Therapeutic Adherence in Kidney Transplanted Adolescents
Keywords:
Adolescent, Kidney Transplantation/psychology, Medication Adherence, Patient ComplianceAbstract
Introduction: Medication adherence affects the prognosis of kidney transplant recipients, since it is a determinant factor for the risk of rejection and loss of renal graft. Adolescence is a stage where many factors can influence therapeutic adherence, including cognitive development, emotional issues and family dysfunction.
The objective of this study was to evaluate therapeutic adherence in adolescents ≥ 12 years‐old who were submitted to kidney transplant and are currently being followed at a Pediatric Kidney Transplantation Center.
Methods: Collection of demographic and clinical data; application of the Treatment Adherence Measure Questionnaire, between June and August 2022.
Results: There were 28 adolescents being followed. All responded to the questionnaire. The median time between transplant and questionnaire was 80 months.
Nine adolescents (32%) answered that they had already forgotten to take medication and 16 (57%) had been careless with the time of the medication. Only 11 adolescents (38%) answered that they have always complied with treatment. Of the patients who responded that they had already forgotten to take their medication, it was found that 6/9 (67%) had infra‐therapeutic tacrolimus levels detected at least once and 3/9 (33%) had acute graft dysfunction. Of the patients who responded that they always adhered to therapy, it was found that only 1 (5%) had infra‐therapeutic tacrolimus levels, without criteria for acute graft dysfunction.
Conclusion: Non‐adherence to therapy is frequent in adolescents submitted to kidney transplant. It is crucial to develop strategies focused on adolescents to improve understanding of the disease and raise awareness of the importance of treatment adherence.
Downloads
References
Coelho A, Vilares C, Silva M, Rodrigues C, Costa M, Gordicho S, et al. Investigação sobre adesão terapêutica na população portuguesa: uma revisão de âmbito. Rev Port Med Geral Fam. 2017;33:262‐76.
Moreno MF. Adesão terapêutica em doentes submetidos a transplante hepático e renal [Dissertation]. Lisboa: Escola Nacional de Saúde Pública, Universidade Nova de Lisboa; 2012.
Stilley CS, DiMartini AF, de Vera ME, Flynn WB, King J, Sereika S, et al. Individual and environmental correlates and predictors of early adherence and outcomes after liver transplantation. Prog Transplant. 2010;20:58‐66; quiz 67. doi: 10.1177/152692481002000110.
Rosenberger J, Geckova AM, van Dijk JP, Nagyova I, Roland R, van den Heuvel WJ, et al. Prevalence and characteristics of noncompliant behaviour and its risk factors in kidney transplant recipients. Transpl Int. 2005;18:1072‐8. doi: 10.1111/j.1432‐2277.2005.00183.x.
Taddeo D, Egedy M, Frappier JY. Adherence to treatment in adolescents. Paediatr Child Health. 2008;13:19‐24. doi: 10.1093/ pch/13.1.19.
Kraenbring MM, Zelikovsky N, Meyers KC. Medication adherence in pediatric renal transplant patients: The role of family functioning and parent health locus of control. Pediatr Transplant. 2019;23:e13346. doi: 10.1111/petr.13346.
Cantú‐Quintanilla G, Ferris M, Otero A, Gutiérrez‐Almaraz A, Valverde‐Rosas S, et al. Validation of the UNC TRxANSITION ScaleTMVersion 3 Among Mexican Adolescents With Chronic Kidney Disease. J Pediatr Nurs. 2015;30:e71‐81. doi: 10.1016/j.pedn.2015.06.011.
Delgado AB, Lima ML. Contributo para a Validação Concorrente de uma Medida de Adesão aos Tratamentos. Psicol Saúde Doenças. 2001;2:81‐100.
Armitage LC, Kassavou A, Sutton S. Do mobile device apps designed to support medication adherence demonstrate efficacy? A systematic review of randomised controlled trials, with meta‐analysis. BMJ Open. 2020;10:e032045. doi: 10.1136/bmjopen‐2019‐032045.
Smith BM, Sharma R, Das A, Aboumatar H, Pitts SI, Day J, et al. Patient and family engagement strategies for children and adolescents with chronic diseases: A review of systematic reviews. Patient Educ Couns. 2021;104:2213‐23. doi: 10.1016/j.pec.2021.02.026.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Ana Barbosa Rodrigues, Ana Raquel Claro, Pedro J. Miguel, Ana Sofia Vilardouro, Sara Costa, Ana Zagalo, Filipa Durão, Patrícia Costa-Reis, Ana Rita Sandes, José Esteves da Silva (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
