Li Yanhua, Chen Yutong, Pu Shijun, Yang Suxia, Zeng Li, Duan Yazhe, Lu Xiaoying, Zhao Wenyu
Department of Organ Transplantation, The First Affiliated Hospital of Naval Medical University, Shanghai, China.
Department of Nursing, The First Affiliated Hospital of Naval Medical University, Shanghai, China.
Pediatr Transplant. 2025 Aug;29(5):e70103. doi: 10.1111/petr.70103.
This study investigated medication adherence and related factors in adolescent kidney transplant recipients receiving immunosuppressive drugs.
Between February and October 2023, 115 adolescent kidney transplant recipients were selected through convenience sampling from follow-up centers in four Chinese tertiary hospitals. The study assessed medication adherence and influencing factors via a general information questionnaire, an adherence assessment scale, a medication belief scale, and an overall happiness scale.
The average medication adherence score was 4.98 ± 2.32 points, with 60.08% (76/115) showing poor adherence. Five of these patients experienced graft failure, resulting in a 6.5% failure rate. No cases of graft failure occurred in those with excellent compliance. Univariate analysis revealed no significant differences in adherence based on sex, age, income, or education (p > 0.05). However, statistically significant differences in medication adherence were observed based on rejection reactions and infections (p < 0.01). Pearson's correlation analysis revealed that higher perceived medication necessity and overall happiness scores were correlated with better adherence (p < 0.05). Linear regression revealed that post-transplant rejection, infections, perceived medication necessity, and overall happiness significantly impacted adherence (p < 0.05).
The high prevalence of poor medication adherence among adolescent kidney transplant recipients highlights the importance for healthcare professionals to focus on monitoring significant post-transplant complications, improving recipients' understanding of the necessity of their medications, and evaluating their overall psychological well-being. Introducing an effective early warning system during home follow-up periods can enable timely interventions to improve medication adherence.
本研究调查了接受免疫抑制药物治疗的青少年肾移植受者的用药依从性及相关因素。
2023年2月至10月,通过便利抽样从中国四家三级医院的随访中心选取了115名青少年肾移植受者。该研究通过一般信息问卷、依从性评估量表、用药信念量表和总体幸福感量表评估用药依从性及影响因素。
用药依从性平均得分为4.98±2.32分,60.08%(76/115)的患者依从性较差。其中5例患者移植失败,失败率为6.5%。依从性极佳的患者未发生移植失败病例。单因素分析显示,依从性在性别、年龄、收入或教育程度方面无显著差异(p>0.05)。然而,基于排斥反应和感染情况,用药依从性存在统计学显著差异(p<0.01)。Pearson相关性分析显示,较高的用药必要性认知和总体幸福感得分与较好的依从性相关(p<0.05)。线性回归分析显示,移植后排斥反应、感染、用药必要性认知和总体幸福感对依从性有显著影响(p<0.05)。
青少年肾移植受者用药依从性差的情况普遍存在,这凸显了医疗保健专业人员关注监测移植后重大并发症、提高受者对用药必要性的理解以及评估其总体心理健康状况的重要性。在家庭随访期间引入有效的早期预警系统可以实现及时干预,以提高用药依从性。