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Medication Adherence Among Pediatric Post-Heart Transplant Patients in a Tertiary Care Hospital
Khawla Kahtani1,2,3, Maha Al Ammari1,2,3,4, Meshary Almeshary1,2,3
1Department of Pharmacy Service, King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia.
Insights
Pediatric heart transplant patients show good medication adherence to immunosuppressive therapy. Continuous monitoring and support are key to maintaining optimal adherence in these young patients.
Area of Science:
- Pediatric Cardiology
- Transplantation Medicine
- Pharmacology
Background:
- Assessing medication adherence is crucial for pediatric heart transplant recipients.
- Immunosuppressive therapy is vital for long-term graft survival post-transplant.
Purpose of the Study:
- To evaluate medication adherence to immunosuppressive therapy in pediatric heart transplant patients.
- To identify factors influencing adherence in this population.
Main Methods:
- A cross-sectional study combining interviews and immunosuppressant drug level monitoring.
- Involved pediatric patients who underwent heart transplantation at a tertiary care center.
Main Results:
- Non-adherence prevalence was 10% (drug levels) and 5% (ITAS).
- Nearly 95% of parents reported consistent medication administration.
- A small percentage (5%) reported occasional missed doses, sometimes due to the child's declining health.
Conclusions:
- Pediatric heart transplant patients generally exhibit good adherence to immunosuppressive medications.
- Sustained adherence requires ongoing monitoring, patient/parent support, and education.
- Interventions should address barriers such as perceived worsening health.
Abstract:
BACKGROUND The present study assessed medication adherence to immunosuppressive therapy in pediatric patients following heart transplantation at a tertiary care center. MATERIAL AND METHODS A cross-sectional interview-based study combined with immunosuppressant level monitoring was conducted to encompass all pediatric patients who underwent heart transplants at King Abdulaziz Medical City-Central Region over a period of 5 months from January to May 2024. RESULTS More than 95% of patients' parents completed the questionnaire and were included in the final analysis. Among the pediatric post-heart transplant patients, 12 (60%) were males, aged from 6 to 18 years. Most patients (85%) were on tacrolimus, while 15% were on tacrolimus and sirolimus. Using the average blood serum drug levels and the ITAS, the prevalence of non-adherence was found to be 10% and 5%, respectively. Almost 95% of parents reported that they "Never forget about taking immunosuppressive medication". However, a small percentage reported occasional carelessness and missing administration of immunosuppressive medication to their children (5%). One reason given for stopping or missing medication were due to the child feeling worse in overall health (5%). CONCLUSIONS The results of this study indicate generally good adherence among pediatric post-heart transplant patients. Most participants demonstrated acceptable adherence behaviors. Continuous monitoring, support, and education are still necessary to maintain optimal adherence.
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