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Published on: April 12, 2021

Improving adherence to medications in pediatric liver transplant recipients

E Shemesh1, R A Annunziato, B L Shneider

  • 1Department of Psychiatry, Mount Sinai Medical Center, New York, NY, USA. Shemesh@email.chop.edu

Pediatric Transplantation
|April 26, 2008
PubMed

Insights

This study shows that increased clinic visits can improve medication adherence in pediatric liver transplant patients. The intervention led to fewer high liver enzyme levels and rejection episodes, suggesting a promising approach for better patient outcomes.

Area of Science:

  • Pediatric Gastroenterology
  • Transplant Medicine
  • Clinical Pharmacology

Background:

  • Medication adherence is critical for pediatric liver transplant recipients.
  • Non-adherence can lead to poor medical outcomes, including graft rejection and liver dysfunction.
  • Tacrolimus blood levels are a key indicator of adherence in these patients.

Purpose of the Study:

  • To evaluate an adherence-improvement protocol for pediatric liver transplant patients.
  • To assess the impact of increased clinic visits on medical outcomes and medication adherence.
  • To determine the cost-effectiveness of the adherence intervention.

Main Methods:

  • A clinical program followed 23 children and adolescents undergoing liver transplant.
  • Non-adherent patients were identified using tacrolimus blood levels.
  • Intervention involved increasing clinic visit frequency for non-adherent patients.
  • Outcomes were compared between a two-year pre-intervention period and the intervention period.

Main Results:

  • The number of patients with high alanine aminotransferase levels (≥100) significantly decreased post-intervention (8 to 4).
  • Rejection episodes decreased from three pre-intervention to none post-intervention.
  • Improved adherence to tacrolimus was observed, though not statistically significant.
  • The intervention did not result in increased outpatient costs.

Conclusions:

  • An adherence-improvement intervention involving increased clinic visits shows promise for pediatric liver transplant recipients.
  • The protocol demonstrated potential in improving key medical outcomes.
  • Larger, controlled studies are necessary to confirm the efficacy of this intervention.

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