移植后不遵守例行预约的相关因素:ADHERE巴西研究
Roberta Lopes Karlburger1, João Henrique Sendrete de Pinho1, Fernando Antônio Basile Colugnati1
1Renal Transplantation Unit, University Hospital, Federal University of Juiz de Fora and Núcleo Interdisciplinar De Estudos e Pesquisas Em Nefrologia, Federal University of Juiz de Fora, Juiz de Fora, Brazil.
Clinical transplantation
|October 7, 2025
概括
移植 (KT) 后不遵守常规门诊预约与患者年龄,移植后的时间以及不遵守免疫抑制剂有关. 医疗系统因素,如团队信任和安排影响错过的约会,建议干预目标.
科学领域:
- 移植医学是一种移植医学.
- 医疗服务研究 医疗服务研究
- 患者的坚持行为患者的坚持行为
背景情况:
- 移植 (KT) 后不遵守常规门诊预约 (NApp) 是一个重要的健康行为,具有不利的结果.
- 在ADHERE BRAZIL研究之前,在移植接受者中发现了NApp的高患病率 (12.7%).
- 了解影响NApp的多层次因素对于改善移植后护理至关重要.
研究的目的:
- 确定移植 (KT) 后与不遵守常规门诊预约 (NApp) 相关的多层次因素.
- 探索患者层面,卫生专业人员 (微) 和移植中心 (meso) 对NApp的影响.
主要方法:
- 一项横截面研究,涉及20个移植中心1105名患者的随机多阶段样本.
- 定义NApp是错过最后五个预定约会中的一个或多个.
- 使用顺序逻辑回归的多变量分析评估了49个基于生态模型的多层变量.
主要成果:
- 与NApp相关的患者层面因素包括年龄较小,KT后5年以上,以及不坚持免疫抑制剂.
- 微层次因素:较高的团队信任分数显示了降低NApp (OR 0.98) 的趋势.
- 中级因素:频繁的 (每月) 咨询和安排困难与NApp的增加有关.
结论:
- 这项研究是首次将医疗系统因素与KT后错过预约联系起来.
- 确定的患者因素有助于识别患NApp.风险的个体.
- 卫生专业人员和移植中心层面的可修改因素为减少NApp和改善结果的干预提供了目标.
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