University of Missouri-Kansas City, School of Nursing and Health Studies, Kansas City, MO, USA.
Indiana University School of Nursing, Indianapolis, IN, USA.
Prog Transplant. 2023 Dec;33(4):318-327. doi: 10.1177/15269248231212906. Epub 2023 Nov 14.
Little is known about COVID-19 impact on patient medication management. The aim was to describe medication management, healthcare team interactions, and adherence during the COVID-19 pandemic in kidney transplant patients and those on the kidney transplant wait list. Using a descriptive, correlational design 340 adults from a midwestern US transplant program were recruited. The Managing Medications in the Midst of a Pandemic Survey measured healthcare team encounters and medication management. The Basel assessment of adherence to medications scale measured medication adherence. The response rate was 35% (119/340). During the pandemic, 88% had practiced/were currently practicing socially distancing, 85% had worn/were currently wearing a face mask in public, 18% had been/were currently diagnosed with COVID-19 and 82% received the vaccine. Medication management: 76% planned and organized their own medications. Healthcare team interactions: 89% met in the office, 20% via phone, 12% telehealth, and 13% delayed seeing a healthcare provider because of COVID-19 concerns. Pharmacy interactions: 11% changed their method of obtaining medications from pharmacy due to social distancing. Medication adherence implementation was problematic with 19% missing a dose; results from the binary logistic regression suggested that those with higher levels of education were more likely to report missing a dose. Patients acted to prevent COVID-19 but some still contracted the virus. The pandemic changed healthcare team medication management interactions. Adherence implementation problems were nearly 20%. Findings are relevant to the transplant healthcare team to understand the impact of a pandemic on patient/team interactions and medication adherence.
关于 COVID-19 对患者药物管理的影响知之甚少。本研究旨在描述 COVID-19 大流行期间肾移植患者和等待肾移植患者的药物管理、医疗团队互动和依从性。采用描述性、相关性设计,从美国中西部的一个移植项目中招募了 340 名成年人。《大流行期间管理药物调查问卷》衡量了医疗团队的接触和药物管理情况。《巴塞尔评估药物依从性量表》衡量了药物依从性。应答率为 35%(119/340)。在大流行期间,88%的人曾实践/正在实践社交距离,85%的人曾在公共场所戴/正在戴口罩,18%的人曾被/正在被诊断为 COVID-19,82%的人接种了疫苗。药物管理:76%的人计划和组织自己的药物。医疗团队互动:89%的人在办公室见面,20%的人通过电话,12%的人通过远程医疗,13%的人因为担心 COVID-19 而推迟看医生。与药房的互动:由于社交距离,11%的人改变了从药房获取药物的方式。药物依从性实施存在问题,19%的人漏服一剂;二元逻辑回归的结果表明,受教育程度较高的人更有可能报告漏服一剂。患者采取行动预防 COVID-19,但仍有人感染了该病毒。大流行改变了医疗团队的药物管理互动。依从性实施问题近 20%。这些发现与移植医疗团队有关,有助于了解大流行对患者/团队互动和药物依从性的影响。