Medication adherence in pediatric and adolescent liver transplant recipients.

摘要: Objective. Nonadherence to medications is a leading cause of morbidity in children and adolescents who have had transplant, yet there are no published data about the use different methods for detecting whether these taking their medications. There also age transition at which child assumes responsibility over This information important if interventions improve adherence contemplated. Methods. We present an analysis obtained first year implementation assessment protocol pediatric liver transplant clinic tertiary medical care center. Data were least 1 before assessments took place. used 5 detection methods. The 4 subjective self-reported, scaled questionnaires answered by nurses, physicians, caregivers, patients. For objective method, standard deviation (SD) was calculated tacrolimus blood levels from each patient time. A higher SD suggests increased variation among patients’ hence more erratic medication taking. asked patients caregivers responsible what reasons not them. outcome measures biopsy-proven rejection episodes, number biopsies regardless results, hospital admissions, in-patient days. Results. An 81 cases (258 assessments) revealed that only method predicted variables (biopsy-proven biopsies) levels. Patients’, clinicians’, caregivers’ reports predictive. Clinicians’ ratings correlated with or caregivers’. occurred approximately 12 years. Forgetfulness cited as most common reason nonadherence caregivers; side effects frequently cited. Conclusions. Our results indicate clinical impression sufficient determine after they transplant. should be used. Interventions targeting address child’s increasing role beginning early adolescence. incorporating could potentially implemented other settings. It form basis evaluation efficacy seeking