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体力活动与肾移植受者免疫抑制药物依从性的关系:一项病例对照研究。

Association between physical activity and immunosuppressive medication adherence among renal transplant recipients: a case-control study.

机构信息

Department of Transplantation, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.

NHC Key Laboratory of Translational Research on Transplantation Medicine, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.

出版信息

BMJ Open. 2024 Oct 29;14(10):e080695. doi: 10.1136/bmjopen-2023-080695.

Abstract

BACKGROUND

Behavioural interventions are closely associated with immunosuppressive medication (IM) adherence. We aimed to explore the relationship between physical activity and IM adherence among renal transplant patients (RTPs) to determine potential interventions to improve IM adherence.

DESIGN

A case-control study.

SETTING

Single-centre study in Changsha, China.

PARTICIPANTS

The study population included 624 RTPs who were adherent to IM and 417 RTPs who were non-adherent to IM.

MAIN OUTCOME MEASURES

Sociodemographic characteristics of RTPs, IM adherence and the association between physical activity patterns or frequency and IM adherence.

RESULTS

The proportion of RTPs who were non-adherent to IM was 40.06%. Compared with RTPs non-adherent to IM, those who were adherent were older, more likely to be married, were evaluated closer to initial time of transplant, had shorter pretransplant waiting times and engaged in more physical activity. Multivariate logistic regression analysis showed that, in the pretransplant stage, only high-frequency aerobic physical activity was significantly associated with IM adherence. However, in the post-transplant stage, patients engaging in low-frequency aerobic physical activity, high-frequency resistance physical activity or high-frequency aerobic physical activity had 2.01, 2.96 and 2.67 times greater odds of being adherent to IM, respectively, compared with patients with no physical activity. RTPs without physical activity in the pretransplant stage were more likely to be adherent to IM if they engaged in post-transplant physical activity. RTPs engaging in low-frequency physical activity in the pretransplant stage may have better IM adherence if they engaged in post-transplant physical activity. RTPs engaging in high-frequency post-transplant physical activity were significantly associated with a greater likelihood of being adherent to IM compared with RTPs engaging in low-frequency post-transplant physical activity.

CONCLUSION

Our study revealed that physical activity, especially in the post-transplant stage, is closely associated with IM adherence and presents a potential intervention for improving IM adherence by RTPs.

摘要

背景

行为干预与免疫抑制药物(IM)的依从性密切相关。我们旨在探讨肾移植受者(RTP)的身体活动与 IM 依从性之间的关系,以确定潜在的干预措施来提高 IM 依从性。

设计

病例对照研究。

地点

中国长沙的单中心研究。

参与者

研究人群包括 624 名依从 IM 的 RTP 和 417 名不依从 IM 的 RTP。

主要观察指标

RTP 的社会人口统计学特征、IM 依从性以及身体活动模式或频率与 IM 依从性之间的关系。

结果

不依从 IM 的 RTP 比例为 40.06%。与不依从 IM 的 RTP 相比,依从 IM 的 RTP 年龄更大、更有可能已婚、在移植初始时间评估更近、移植前等待时间更短、从事更多的身体活动。多变量 logistic 回归分析显示,在移植前阶段,只有高频有氧运动与 IM 依从性显著相关。然而,在移植后阶段,与无身体活动的患者相比,进行低频有氧运动、高频阻力运动或高频有氧运动的患者分别具有 2.01、2.96 和 2.67 倍的 IM 依从性优势。在移植前阶段没有身体活动的 RTP,如果在移植后进行身体活动,更有可能依从 IM。在移植前阶段进行低频身体活动的 RTP,如果在移植后进行身体活动,可能会更好地依从 IM。与进行低频移植后身体活动的 RTP 相比,进行高频移植后身体活动的 RTP 与更有可能依从 IM 显著相关。

结论

我们的研究表明,身体活动,特别是在移植后阶段,与 IM 依从性密切相关,为提高 RTP 的 IM 依从性提供了一种潜在的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e73/11529692/3355cee5661a/bmjopen-14-10-g001.jpg

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