Shafiekhani Mojtaba, Shahabinezhad Farbod, Tavakoli Zahra, Tarakmeh Tahereh, Haem Elham, Sari Negar, Nasirabadi Shohreh, Dehghani Masoud
Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Shiraz Transplant Center, Abu-Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Front Pharmacol. 2023 Feb 24;14:1051350. doi: 10.3389/fphar.2023.1051350. eCollection 2023.
Transplanted organ survival after solid organ transplantation highly correlates with the adherence levels of the patients to their immunosuppressive drugs. On the other hand, one of the main goals of liver transplantation is to increase the overall quality of life (QOL) for the patient. This study is aimed to analyze the relationship between adherence and QOL in adult liver transplant recipients of the biggest liver transplant center in Asia. All of the included patients were older than 18 years and at least 6 months had passed from their liver transplantation. The adherence level was measured with BAASIS method and the QOL was assessed by SF-36 questionnaire in real-time interviews. The relationship between adherence and different aspects of QOL in addition to qualitative and quantitative influential factors on these two outcomes was calculated with statistical analysis. Among the 122 included patients, 41% of the were categorized in the non-adherent group. The most important reasons for non-adherence in these patients included forgetfulness (62%), lack of medication (12%), financial problems for drug supply (9%), and side effects (2%). According to the results of the multivariate linear regression model, rejection was the only influential factor in the occurrence of non-adherence among patients (OR = 8.226 CI (1.404-48.196)). The overall mean QOL score of patients was reported 51.09 ± 21.86. The lowest is given to social functioning, while mental health has achieved the highest score. The mean QOL scores in different dimensions in patients with adherence were higher than non-adherents, which was only significant in mental health (-value = 0.01). Additionally, in total scores related to Physical Composite Score (PSC) and Mental Composite Score (MCS), the mean MSC scores in adherent patients were significantly higher than non-adherent patients (-value: 0.02). Although adherent patients have an overall greater QOL, the only meaningful effect on QOL total score was from income level. The overall QoL score has been in all parameters higher in the adherent group compared with non-adherent patients. The difference in QoL was most meaningfully significant in mental composite score among other parameters of QoL.
实体器官移植后移植器官的存活与患者对免疫抑制药物的依从程度高度相关。另一方面，肝移植的主要目标之一是提高患者的整体生活质量（QOL）。本研究旨在分析亚洲最大的肝移植中心成年肝移植受者的依从性与生活质量之间的关系。所有纳入的患者年龄均超过18岁，且肝移植术后至少已过去6个月。采用BAASIS方法测量依从水平，并通过SF-36问卷在实时访谈中评估生活质量。通过统计分析计算了依从性与生活质量不同方面之间的关系，以及这两个结果的定性和定量影响因素。在122名纳入患者中，41%被归类为不依从组。这些患者不依从的最重要原因包括健忘（62%）、药物短缺（12%）、药物供应的经济问题（9%）和副作用（2%）。根据多元线性回归模型的结果，排斥反应是患者中发生不依从的唯一影响因素（OR = 8.226，CI（1.404 - 48.196））。患者的总体生活质量平均得分为51.09±21.86。社会功能得分最低，而心理健康得分最高。依从患者在不同维度的生活质量平均得分高于不依从患者，这仅在心理健康方面显著（p值 = 0.01）。此外，在与身体综合评分（PSC）和精神综合评分（MCS）相关的总分中，依从患者的平均MCS得分显著高于不依从患者（p值：0.02）。虽然依从患者的总体生活质量更高，但对生活质量总分唯一有意义的影响来自收入水平。与不依从患者相比，依从组在所有参数上的总体生活质量得分都更高。在生活质量的其他参数中，生活质量差异在精神综合评分方面最具显著意义。
