阻碍免疫抑制药物的障碍 胸部移植患者的药物坚持:初步发现
Sparkle Springfield-Trice1, Grishma Reddy1,2, Cara Joyce2
1Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL 60153, USA.
概括
近一半的胸部移植接受者与免疫抑制药物坚持斗争. 诸如饮食和应对歧视等因素显著影响了坚持,突出了需要以社会决定因素为重点的干预措施的需要.
科学领域:
- 移植医学 移植医学
- 医疗保健服务研究 医疗服务研究
- 心理社会健康 心理健康
背景情况:
- 终身免疫抑制对于胸部移植接受者来说至关重要,以防止移植损失和死亡.
- 越来越多的胸部器官移植率需要更深入地了解治疗坚持障碍.
- 现有的文献可能无法完全解决所有潜在的障碍,以实现移植后药物坚持.
研究的目的:
- 确定与胸部移植接收者免疫抑制剂不坚持相关的社会人口统计学,移植相关,医疗保健准入,移植后治疗和心理社会因素.
- 在胸部器官移植的背景下,探索以前没有考虑的治疗障碍.
- 为改善移植后护理和药物坚持提供初步见解.
主要方法:
- 这是一项单一地点的横截面研究,涉及65名胸部 (心脏和肺) 移植接受者.
- 通过电话采访收集数据,评估各种潜在的坚持因素.
- 分析药物坚持模式及其与已识别的变量之间的相关性.
主要成果:
- 近一半 (49.2%) 的参与者表现出免疫抑制药物不坚持 (46.9%的心脏,51.5%肺).
- 在四周内,20%的患者错过了剂量,40%的患者迟到了,1%的患者停止了服用药物.
- 不遵守与更差的饮食质量,更少的并发病,和不适应应对所感知的歧视相关联.
结论:
- 健康的社会决定因素,特别是移植后的治疗和心理社会因素,对于理解药物坚持至关重要.
- 解决这些变量可能会增强免疫抑制剂的坚持,并改善患者的长期结果.
- 为了验证发现并制定有针对性的干预措施,对更大的队列进行进一步研究是必不可少的.
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