人口因素,药物坚持和移植后健康结果:一个纵向多层次建模方法
Michael O Killian1,2, Callie W Little3, Savarra K Howry3
1College of Social Work, University Center, Florida State University, 296 Champions Way, Building C - Suite 2500, Tallahassee, FL, USA. mkillian@fsu.edu.
Journal of clinical psychology in medical settings
|August 17, 2023
概括
儿科移植患者长途药物坚持显著影响结果,如拒绝和住院. 干预措施应针对高风险人群,特别是青少年,以改善药物服药.
科学领域:
- 儿科固体器官移植 儿科固体器官移植
- 免疫抑制药物的坚持 免疫抑制药物的坚持
- 移植研究成果 研究成果
背景情况:
- 关于儿童固体器官移植中长期免疫抑制药物不服药的研究有限.
- 了解坚持模式及其与患者人口统计学和移植后结果的联系至关重要.
研究的目的:
- 在儿童脏,肝脏和心脏移植接受者中使用药物水平可变性指数 (MLVI) 检查药物坚持度的纵向变化.
- 调查粘附变异性与移植后结果之间的关联,包括晚期急性排斥和住院治疗.
- 探索患者因素与移植结果之间的关系中坚持的调解作用.
主要方法:
- 对332名儿科实体器官移植接受者10年来分析了纵向MLVI坚持数据.
- 数据来自美国器官共享网络,电子健康记录和MLVI值.
- 采用多层调解建模来评估变化和预测关系.
主要成果:
- 在患者之间观察到MLVI值的变化较大,而不是在患者内纵向观察到的.
- MLVI值显著预测了晚期急性排斥和住院.
- MLVI部分介导患者因子和移植后结果,青少年显示干预措施的潜在益处.
结论:
- 在儿科实体器官移植中,对药物坚持的纵向评估至关重要.
- 患者特定的坚持模式会影响移植结果,强调需要个性化的方法.
- 针对高风险患者,特别是青少年的有针对性的干预措施可以改善药物坚持和移植成功.
相关概念视频
Kidney Transplant III: Nursing Management
39
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
39
Longitudinal Studies
187
Longitudinal studies are also widely used in other medical and social science fields. For instance, in cardiovascular research, they can monitor patients' health over decades to identify risk factors for heart disease, such as high cholesterol or smoking, and evaluate the long-term effectiveness of preventive measures. Similarly, in mental health studies, researchers might follow individuals from adolescence into adulthood to understand the development and progression of conditions like...
187
Longitudinal Research
12.0K
Sometimes we want to see how people change over time, as in studies of human development and lifespan. When we test the same group of individuals repeatedly over an extended period of time, we are conducting longitudinal research. Longitudinal research is a research design in which data-gathering is administered repeatedly over an extended period of time. For example, we may survey a group of individuals about their dietary habits at age 20, retest them a decade later at age 30, and then again...
12.0K
Kidney Transplant I: Introduction
29
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
29
Analysis of Population Pharmacokinetic Data
293
Analysis of population pharmacokinetic data involves studying the behavior of drugs within diverse populations to understand their pharmacokinetic parameters. Traditional pharmacokinetic methods typically involve collecting samples from a few individuals and estimating these parameters. While these methods are commonly used, they have limitations in capturing the variability in drug response among individuals or heterogeneous populations. Population pharmacokinetics is employed to address these...
293
Factors Affecting Protein-Drug Binding: Patient-Related Factors
82
Protein-drug binding, a pivotal aspect of pharmacokinetics, is subject to considerable variability influenced by an array of patient-related factors. The intricate interplay of age, individual differences, and pathological conditions significantly impact the binding dynamics and subsequent pharmacological effects.
Age stands as a key determinant in protein-drug binding. Neonates, characterized by low albumin content, experience heightened concentrations of unbound drugs such as phenytoin and...
Age stands as a key determinant in protein-drug binding. Neonates, characterized by low albumin content, experience heightened concentrations of unbound drugs such as phenytoin and...
82


