Search

Your search keyword '"Samira Scalso de Almeida"' showing total 8 results
Start Over Author "Samira Scalso de Almeida" Publication Year Range Last 10 years
8 results on '"Samira Scalso de Almeida"'

1. Trust in the Transplant Team Associated With the Level of Chronic Illness Management—A Secondary Data Analysis of the International BRIGHT Study

Author

Juliane Mielke, Maan Isabella Cajita, Kris Denhaerynck, Sabine Valenta, Fabienne Dobbels, Cynthia L. Russell, Sabina De Geest, the BRIGHT study team, Luis Almenar-Bonet, Andrea Cotait Ayoub, Fernanda Barone, Lut Berben, Andrée Bernard, Vicens Brossa-Loidi, Karyn Ryan Canales, Katherine St. Clair, Johan Van Cleemput, Bernice Coleman, Marisa G. Crespo-Leiro, Sandra Cupples, Patricia M. Davidson, Bartira De Aguiar Roza, Samira Scalso De Almeida, Paolo De Simone, Andreas Doesch, Flavio R. Epstein, Ashi Firouzi, Grant Fisher, Maureen Flattery, Albert Groenewoud, Haissam Haddad, Michelle Harkess, Eva Horvath, Alain Jean Poncelet, Annemarie Kaan, Andrew Kao, Stella Kozuszko, Christiane Kugler, Ugolino Livi, Kristin Ludrosky, Joanne Maddicks-Law, Magali Michel, Tara Miller, Paul Mohacsi, Maria Molina, Linda Ohler, Gareth Parry, Luciano Potenta, Cheryl Riotto, Carmen Segura Saint-Gerons, Laurent Sebbag, Javier Segovia-Cubero, and Jacqueline Trammell

Subjects
trust, chronic illness management, heart transplant, transplant team, behavioral outcomes, Specialties of internal medicine, RC581-951
Abstract

A trustful relationship between transplant patients and their transplant team (interpersonal trust) is essential in order to achieve positive health outcomes and behaviors. We aimed to 1) explore variability of trust in transplant teams; 2) explore the association between the level of chronic illness management and trust; 3) investigate the relationship of trust on behavioral outcomes. A secondary data analysis of the BRIGHT study (ID: NCT01608477; https://clinicaltrials.gov/ct2/show/NCT01608477?id=NCT01608477&rank=1) was conducted, including multicenter data from 36 heart transplant centers from 11 countries across four different continents. A total of 1,397 heart transplant recipients and 100 clinicians were enrolled. Trust significantly varied among the transplant centers. Higher levels of chronic illness management were significantly associated with greater trust in the transplant team (patients: AOR= 1.85, 95% CI = 1.47–2.33, p < 0.001; clinicians: AOR = 1.35, 95% CI = 1.07–1.71, p = 0.012). Consultation time significantly moderated the relationship between chronic illness management levels and trust only when clinicians spent ≥30 min with patients. Trust was significantly associated with better diet adherence (OR = 1.34, 95%CI = 1.01–1.77, p = 0.040). Findings indicate the relevance of trust and chronic illness management in the transplant ecosystem to achieve improved transplant outcomes. Thus, further investment in re-engineering of transplant follow-up toward chronic illness management, and sufficient time for consultations is required.

Published
2024
Full Text
View/download PDF

2. Comparison of outcomes and costs of surgery versus sclerotherapy to treat hydrocele

Author

Fernando Korkes, Saulo Borborema Teles, Matheus Prado Nascimento, Samira Scalso de Almeida, and Artur Martins Codeço

Subjects
Testicular hydrocele, Sclerotherapy, Cost and cost analysis, Cost-benefit analysis, Medicine
Abstract

ABSTRACT Objective: To evaluate the outcomes and costs associated with surgery versus sclerotherapy as treatment of hydroceles. Methods: A total of 53 men consecutively treated for hydrocele at our organization, between December 2015 and June 2019, were retrospectively analyzed (39 with Jaboulay technique and 14 with sclerotherapy). All charts were reviewed, assessing clinical data, ultrasound findings, surgical data, and post-procedure outcomes. The hospital finance department calculated the cost of outpatient evaluation, complementary tests, supplies, drugs, and professionals’ costs throughout all procedures. Results: The median age for both groups was similar (58 and 65 years old). Comorbidities were less frequent in the Surgery Group (20; 51%) than in the Sclerotherapy Group (14; 100%, p

Published
2021
Full Text
View/download PDF

3. Quality improvement model (IHI) as a strategy to implement a sepsis protocol in a public hospital in Brazil

Author

Leidy Katerine Calvo Nates, Antônio Capone Neto, Adriano José Pereira, Eliézer Silva, Guilherme de Paula Pinto Schettino, Ana Paula Metran Nascente Pereira, Adolfo Wenjaw Liao, Midgley Gonzales, Rosana Mandelbaum, Fernanda Domingos Giglio Petreche, Cristina Tiemi Amadatsu, Carolina Devite Bittante, Leonardo Jose Rolim Ferraz, Carlos Alberto Eduardo Gomes, Rodrigo Vone Fregoneze, Rodrigo NG Taniguchi, Gabriela Sato, Marcia Galluci Pinter, Adriana Martins da Silva, Maitê Augusta C C Rossetto, Eliton Paulo Leite Lourenco, Samira Scalso de Almeida, Silvana Aparecida Eleodoro dos Santos, Marcelo Longarezi Valvassora, Maria Aparecida Machado, Caroline Gusmão Alves Santos, Camila de Carvalho Gambin, Natalia Nunez de Souza, Priscilla Santini Ramalho, Érika Brosco Lima, Maria Caroline de Oliveira, Andreza Moreira Santana, Andreza Michele Secolo, Denise Simas Lamarão, Francisco Neves Pereira, Ana Paula Doria Santos, Claudia Regina Basilio Foglietto, Priscila Reimão de Melo Fortunato, Ernane Cruz da Silva, and Ana Paula de Oliveira Ribeiro

Subjects
Medicine (General), R5-920
Abstract

A major challenge for hospitals in low-income and middle-income countries is to improve management of patients diagnosed with sepsis. The objective of the present study was to evaluate the Institute for Healthcare Improvement (IHI) Model as a strategy to implement a managed sepsis protocol aimed at reducing sepsis mortality. We performed a longitudinal, prospective, non-randomised study using PDSA cycles for translating and implementing improvement actions and tools. Baseline case mortality/case fatality data were collected, and compliance rates were evaluated according to the Surviving Sepsis Campaign guidelines (3-hour care-bundle). Sepsis multidisciplinary work teams were designated and were responsible to develop Driver Diagrams and implement process changes in the intensive care unit, wards and emergency department. Satisfaction levels of healthcare professionals were assessed (balance variables). The study was carried out in a public quaternary hospital, in São Paulo city, Brazil (Hospital Municipal da Vila Santa Catarina). The number of patients with sepsis studied was 416 who were followed over a 15-month period. The data analyses were carried out by statistical process control. Case fatality rates were kept below a prespecified target of 25% (15.9%) during the period. Satisfaction level of the participating staff was high (95.2%) and 71% of participants reported no work overload. The IHI model was found to be a feasible and useful strategy for implementing a sepsis management clinical protocol.

Published
2020
Full Text
View/download PDF

4. Practice patterns to improve pre and post-transplant medication adherence in heart transplant centres: a secondary data analysis of the international BRIGHT study

Author

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

Subjects
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
Full Text
View/download PDF

5. Heart transplant centers with multidisciplinary team show a higher level of chronic illness management – Findings from the International BRIGHT Study

Author

Kris Denhaerynck, Albert Groenewoud, Sandra Cupples, Annemarie Kaan, Christiane Kugler, Eva Horvath, Javier Segovia-Cubero, Paolo De Simone, Paul Mohacsi, Andrew Kao, Eva Baumgartner, Ashi Firouzi, Bernice Coleman, Samira Scalso de Almeida, Linda Ohler, Joanne Maddicks-Law, Gareth Parry, Ugolino Livi, Haissam Haddad, María G. Crespo-Leiro, Karyn Ryan Canales, M. Harkess, Gabriele Berger, Kristin Ludrosky, Johan Van Cleemput, Jacqueline Trammell, Andrée Bernard, Katherine St. Clair, V. Manfredini, Christine Vetter, Maan Isabella Cajita, L. Sebbag, Vicens Brossa-Loidi, Grant Fisher, Tara Miller, Maria Molina, Cynthia L. Russell, Remon Helmy, Sandra Schönfeld, Andrea Cotait Ayoub, Carmen Segura Saint-Gerons, Lut Berben, Andreas O. Doesch, Magali Michel, Fernanda Barone, Maureen Flattery, Luis Almenar-Bonet, Fabienne Dobbels, Cheryl Riotto, Alain Poncelet, S. Kozuszko, Sabina De Geest, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Centre du cancer, and UCL - (SLuc) Département cardiovasculaire

Subjects
Male, Pulmonary and Respiratory Medicine, education, Pharmacist, Heart transplantation, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Multidisciplinary team, 03 medical and health sciences, 0302 clinical medicine, Nursing, Chronic illness management, Multidisciplinary approach, Secondary analysis, Humans, Medicine, 030212 general & internal medicine, Patient Care Team, Social work, business.industry, Disease Management, Middle Aged, Structural factor, Cross-Sectional Studies, Chronic Disease, Multivariate Analysis, Female, Multidisciplinary teams, Delivery of Health Care, Heart Transplantation, Cardiology and Cardiovascular Medicine, business, Physical therapist
Abstract

OBJECTIVES: The objectives of this study were to: (1) explore the proportion of HTx centers that have a multidisciplinary team and (2) assess the relationship between multidisciplinarity and the level of chronic illness management (CIM). BACKGROUND: The International Society for Heart and Lung Transplantation (ISHLT) recommends a multidisciplinary approach in heart transplant (HTx) follow-up care but little is known regarding the proportion of HTx centers that meet this recommendation and the impact on patient care. HTx centers with a multidisciplinary team may offer higher levels of CIM, a care model that has the potential to improve outcomes after HTx. METHODS: We conducted a secondary analysis of the BRIGHT study, a cross-sectional study in 11 countries. Multidisciplinarity in the 36 HTx centers was assessed through HTx director reports and was defined as having a team that was composed of physician(s), nurse(s), and another healthcare professional (either a social worker, psychiatrist, psychologist, pharmacist, dietician, physical therapist, or occupational therapist). CIM was assessed with the Patient Assessment of Chronic Illness Care (PACIC). Multiple linear regression assessed the relationship between multidisciplinarity and the level of CIM. RESULTS: Twenty-nine (80.6%) of the HTx centers had a multidisciplinary team. Furthermore, multidisciplinarity was significantly associated with higher levels of CIM (β = 5.2, P = 0.042). CONCLUSION: Majority of the HTx centers follows the ISHLT recommendation for a multidisciplinary approach. Multidisciplinarity was associated with CIM and point toward a structural factor that needs to be in place for moving toward CIM. ispartof: Heart & Lung vol:46 issue:5 pages:351-356 ispartof: location:United States status: published

Published
2017
Full Text
View/download PDF

6. Health literacy in heart transplantation: Prevalence, correlates and associations with health behaviors—Findings from the international BRIGHT study

Author

Maan Isabella Cajita, Kris Denhaerynck, Fabienne Dobbels, Lut Berben, Cynthia L. Russell, Patricia M. Davidson, Sabina De Geest, Maria G. Crespo-Leiro, Sandra Cupples, Paolo De Simone, Albert Groenewoud, Christiane Kugler, Linda Ohler, Johan Vanhaecke, Alain Jean Poncelet, Laurent Sebbag, Magalu Michel, Andrée Bernard, Andreas Doesch, Ugolino Livi, Valentina Manfredini, Vicens Brossa Loidi, Javier Segovia, Luis Amenar, Carmen Segura Saint-Gerons, Paul Mohacsi, 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, Katherine St. Clair, Andrew Kao, Maria Molina, Karyn Ryan Canalesa, Samira Scalso de Almeida, A. Cotait Ayoub, Fernanda Barone, Michelle Harkess, and Joanne Maddicks-Law

Subjects
Graft Rejection, Male, Gerontology, Internationality, Cross-sectional study, medicine.medical_treatment, Health Behavior, physical activity, multicenter, 030204 cardiovascular system & hematology, heart transplantation, Logistic regression, 0302 clinical medicine, Prevalence, 030212 general & internal medicine, Heart transplantation, Age Factors, Middle Aged, Prognosis, health behaviors, Survival Rate, Female, Cardiology and Cardiovascular Medicine, Immunosuppressive Agents, Needs Assessment, Adult, Pulmonary and Respiratory Medicine, Health literacy, 03 medical and health sciences, Sex Factors, Transplantation Immunology, Confidence Intervals, medicine, Humans, survey, Life Style, Survival rate, Aged, Transplantation, business.industry, Odds ratio, Stepwise regression, Confidence interval, Health Literacy, Cross-Sectional Studies, Logistic Models, Patient Compliance, Surgery, business, health literacy, Heart Transplantation, Demography
Abstract

Health literacy (HL) is a major determinant of health outcomes; however, there are few studies exploring the role of HL among heart transplant recipients. The objectives of this study were to: (1) explore and compare the prevalence of inadequate HL among heart transplant recipients internationally; (2) determine the correlates of HL; and (3) assess the relationship between HL and health-related behaviors.A secondary analysis was conducted using data of the 1,365 adult patients from the BRIGHT study, an international multicenter, cross-sectional study that surveyed heart transplant recipients across 11 countries and 4 continents. Using the Subjective Health Literacy Screener, inadequate HL was operationalized as being confident in filling out medical forms none/a little/some of the time (HL score of 0 to 2). Correlates of HL were determined using backward stepwise logistic regression. The relationship between HL and the health-related behaviors were examined using hierarchical logistic regression.Overall, 33.1% of the heart transplant recipients had inadequate HL. Lower education level (adjusted odds ratio [AOR] 0.24, p0.001), unemployment (AOR 0.69, p = 0.012) and country (residing in Brazil, AOR 0.25, p0.001) were shown to be associated with inadequate HL. Heart transplant recipients with adequate HL had higher odds of engaging in sufficient physical activity (AOR 1.6, p = 0.016). HL was not significantly associated with the other health behaviors.Clinicians should recognize that almost one third of heart transplant participants have inadequate health literacy. Furthermore, they should adopt communication strategies that could mitigate the potential negative impact of inadequate HL.

Published
2017
Full Text
View/download PDF

7. Prevalence of Medication Nonadherence to co-medication Compared to immunosuppressants in Heart Transplant Recipients: Findings From the International Cross-sectional BRIGHT Study

Author

Bartira de Aguiar Roza, Andreas O. Doesch, Magali Michel, Gareth Parry, Andrea Cotait Ayoub, Marisa G. Crespo-Leiro, Paul Mohacsi, M. Harkess, Albert Groenewoud, Tara Miller, Sabina De Geest, Maureen Flattery, Christiane Kugler, Linda Ohler, Johan Van Cleemput, Cheryl Riotto, Fabienne Dobbels, Andrée Bernard, Haissam Haddad, Sandra Cupples, Nancy M. Albert, Remon Helmy, Flavio Epstein, Eva Horvath, Fernanda Barone, Karyn Ryan Canales, Annemarie Kaan, Paolo De Simone, Lut Berben, Samira Scalso de Almeida, Jacqueline Trammell, Ugolino Livi, Ashi Firouzi, Carmen Segura Saint-Gerons, Kris Denhaerynck, Luis Almenar-Bonet, Javier Segovia-Cubero, Alain Poncelet, S. Kozuszko, Kristin Ludrosky, Andrew Kao, Cynthia L. Russell, Grant Fisher, Katherine St. Clair, Bernice Coleman, Joanne Maddicks-Law, Luciano Potena, Maria Molina, L. Sebbag, Vicens Brossa-Loidi, Pôle Médico-Chirurgical de Transplantation Cardiaque Adulte, Hospices Civils de Lyon (HCL)-Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Laboratoire d'Excellence : Lipoprotéines et Santé : prévention et Traitement des maladies Inflammatoires et du Cancer (LabEx LipSTIC), Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Paris-Sud - Paris 11 (UP11)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut Gustave Roussy (IGR)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM)-Fédération Francophone de la Cancérologie Digestive, FFCD-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Centre National de la Recherche Scientifique (CNRS)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université de Montpellier (UM), Ecole Polytech Fed Lausanne, Lab Phys Complex Matter, CH-1015 Lausanne, Switzerland, Laboratoire Informatique d'Avignon (LIA), Avignon Université (AU)-Centre d'Enseignement et de Recherche en Informatique - CERI, Ecole Superieure de Physique et de Chimie Industrielles de la Ville de Paris (ESPCI Paris), Université Paris sciences et lettres (PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut Gustave Roussy (IGR)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM)-Fédération Francophone de la Cancérologie Digestive, FFCD-Université de Montpellier (UM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Paris-Sud - Paris 11 (UP11)-École pratique des hautes études (EPHE)-Institut Gustave Roussy (IGR)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc (CRLCC - CGFL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Fédération Francophone de la Cancérologie Digestive, FFCD-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Etablissement français du sang [Bourgogne-France-Comté] (EFS [Bourgogne-France-Comté])-Centre National de la Recherche Scientifique (CNRS)-Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Université de Franche-Comté (UFC)-Université de Montpellier (UM), Ecole Supérieure de Physique et de Chimie Industrielles (ESPCI), and Mairie de Paris

Subjects
Adult, Male, medicine.medical_specialty, cross-sectional, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Psychological intervention, 030230 surgery, Logistic regression, heart transplantation, 03 medical and health sciences, ADHERENCE, 0302 clinical medicine, immunosuppressants, Internal medicine, Prevalence, Humans, Medicine, co-medications, Pharmacology (medical), adherence, Pharmacology & Pharmacy, 030212 general & internal medicine, Aged, Heart transplantation, Pharmacology, Science & Technology, business.industry, international, medication adherence, Drug holiday, Odds ratio, Middle Aged, 3. Good health, Discontinuation, Cross-Sectional Studies, Logistic Models, Co medication, Medication Nonadherence, Female, Self Report, business, Life Sciences & Biomedicine, Immunosuppressive Agents
Abstract

PURPOSE: To assess and compare the prevalence of medication nonadherence (MNA) (implementation and persistence) to immunosuppressants and co-medications in heart transplant recipients. METHODS: MNA prevalence was assessed using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (self-report) and compared using logistic regression in a 4-continent sample of 1397 heart transplant recipients from 36 heart transplant centers in 11 countries. FINDINGS: MNA was significantly (α = 0.05) higher to co-medications than to immunosuppressants (taking nonadherence: 23.9% vs 17.3%; odds ratio [OR] = 1.5; 95% CI, 1.30-1.73; drug holiday: 5.7% vs 1.9%; OR = 3.17; 95% CI, 2.13-4.73; dose alteration: 3.8% vs 1.6%; OR = 2.46; 95% CI, 1.49-4.06; and discontinuation: 2.6% vs 0.5%; OR = 5.15; 95% CI, 2.36-11.20). IMPLICATIONS: The observed MNA necessitates adherence-enhancing interventions encompassing the entire post-heart transplant medication regimen. ClinicalTrials.gov identifier: NCT01608477. ispartof: CLINICAL THERAPEUTICS vol:41 issue:1 pages:130-136 ispartof: location:United States status: published

Published
2018
Full Text
View/download PDF

8. Intestinal and multivisceral transplantation

Author

Marina Gabrielle Epstein, Roberto Ferreira Meirelles Júnior, Rodrigo Andrey Rocco, Andreia Silva Evangelista, Luiz Gustavo Guedes Diaz, Lilian Amorim Curvelo, Fernando Luis Pandullo, Marcelo de Melo Viveiros, Sérgio Paiva Meira Filho, Marcela Balbo Rusi, Celso Eduardo Lourenço Matielo, Marcelo Bruno de Rezende, Marcio Dias de Almeida, Samira Scalso de Almeida, Jefferson André da Silva Alves, P.R. Salvalaggio, G. Felga, Douglas Bastos Neves, Pamella Tung Pedroso, and Bianca Della Guardia

Subjects
medicine.medical_specialty, Transplantation immunology, medicine.medical_treatment, lcsh:Medicine, Transplantation chimera, Transplantation Chimera, Review, Liver transplantation, medicine, small/transplantation, Humans, Intensive care medicine, Imunologia de transplantes, Intestino delgado/transplante, Quimeras de transplante, Transplantation, business.industry, lcsh:R, Graft Survival, Immunosuppression, General Medicine, Organ Transplantation, Revisão, medicine.disease, Tacrolimus, Surgery, Liver Transplantation, Intestine, Intestines, Multivisceral transplantation, Viscera, Graft-versus-host disease, Parenteral nutrition, surgical procedures, operative, Tissue donors, Transplante, Doadores de tecidos, business
Abstract

Intestinal transplantation has shown exceptional growth over the past 10 years. At the end of the 1990’s, intestinal transplantation moved out of the experimental realm to become a routine practice in treating patients with severe complications related to total parenteral nutrition and intestinal failure. In the last years, several centers reported an increasing improvement in survival outcomes (about 80%), during the first 12 months after surgery, but long-term survival is still a challenge. Several advances led to clinical application of transplants. Immunosuppression involved in intestinal and multivisceral transplantation was the biggest gain for this procedure in the past decade due to tacrolimus, and new inducing drugs, mono- and polyclonal anti-lymphocyte antibodies. Despite the advancement of rigid immunosuppression protocols, rejection is still very frequent in the first 12 months, and can result in long-term graft loss. The future of intestinal transplantation and multivisceral transplantation appears promising. The major challenge is early recognition of acute rejection in order to prevent graft loss, opportunistic infections associated to complications, post-transplant lymphoproliferative disease and graft versus host disease; and consequently, improve results in the long run.

Published
2015

Catalog

Books, media, physical & digital resources
See catalog results