1. Practice patterns to improve pre and post-transplant medication adherence in heart transplant centres: a secondary data analysis of the international BRIGHT study
- Author
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Yuliya, Senft, Monika, Kirsch, Kris, Denhaerynck, Fabienne, Dobbels, Remon, Helmy, Russell, Cynthia L., Lut, Berben, Sabina De Geest, Crespo-Leiro, Maria G., Sandra, Cupples, DE SIMONE, Paolo, Albert, Groenewoud, Christiane, Kugler, Linda, Ohler, Johan Van Cleemput, Alain Jean Poncelet, Laurent, Sebbag, Magali, Michel, Andrée, Bernard, Andreas, Doesch, Ugolino, Livi, Valentina, Manfredini, Vicens Brossa Loidi, Javier, Segovia, Luis, Almoner, Carmen Segura Saint-Gerons, Paul, Mohasco, Eva, Horvath, Cheryl, Riotto, Gareth, Parry, Ashi, Firouzi, Stella, Kozuszko, Haissam, Haddad, Annemarie, Kaan, Grant, Fisher, Tara, Miller, Maureen, Flattery, Kristin, Ludrosky, Bernice, Coleman, Jacqueline, Trammell, Clair, Katherine S. t., Andrew, Kao, Maria, Molina, Karyn Ryan Canales, Samira Scalso de Almeida, Cotait Ayoub, A., Fernanda, Barone, Michelle, Harkess, and Joanne, Maddicks-Law
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medicine.medical_specialty ,medicine.medical_treatment ,Medication adherence ,Heart transplantation ,030204 cardiovascular system & hematology ,030230 surgery ,Adherence assessment ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Risk factor ,Intensive care medicine ,Pre and post ,Advanced and Specialized Nursing ,Practice patterns ,business.industry ,adherence assessment ,medication adherence ,practice patterns ,Secondary data ,Transplantation ,Medical–Surgical Nursing ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background:As medication non-adherence is a major risk factor for poor post-transplant outcomes, we explored how adherence is assessed, enhanced and integrated across the transplant continuum.Aim:The aim of this study was to study practice patterns regarding pre- and post-transplant medication adherence assessment and interventions in international heart transplant centres.Methods:We used data from the Building Research Initiative Group: chronic illness management and adherence in heart transplantation (BRIGHT) study, a cross-sectional study conducted in 36 heart transplant centres in 11 countries. On a 27-item questionnaire, 100 clinicians (range one to five per centre) reported their practice patterns regarding adherence assessment and intervention strategies pre-transplant, immediately post-transplant, less than one year, and one or more year post-transplant. Educational/cognitive, counselling/behavioural and psychosocial/affective strategies were assessed. Clinicians’ responses (intervention present vs. absent; or incongruence in reporting intervention) were aggregated at the centre level.Results:The adherence assessment method most commonly used along the transplant continuum was questioning patients (range 75–88.9%). Pre-transplant, all three categories of intervention strategy were applied. Providing reading materials (82.9%) or instructions (68.6%), involving family or support persons in education (91.4%), and establishing partnership (91.4%) were used most frequently. Post-transplant, strategies closely resembled those employed pre-transplant. Training patients (during recovery) and cueing were more often applied during hospitalisation (74.3%). After the first year post-transplant, except for motivational interviewing (25.7–28.6%), the number of strategies decreased.Conclusions:Across the transplant continuum, diverse adherence interventions are implemented; however, post-transplant, the frequency of adherence interventions decreases. Therefore, increased investment is necessary in long-term adherence interventions.
- Published
- 2017
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