Practice patterns to improve pre and post-transplant medication adherence in heart transplant centres: a secondary data analysis of the international BRIGHT study. (April 2018)

• Record Type: Journal Article
• Authors: Senft, Yuliya; Kirsch, Monika; Denhaerynck, Kris; Dobbels, Fabienne; Helmy, Remon; Russell, Cynthia L; Berben, Lut; De Geest, Sabina
• Other Names: King-Shier Kathryn guest-editor.; Ski Chantal guest-editor.; Fitzsimons Donna guest-editor.; Crespo-Leiro Maria G non-byline-author.; Cupples Sandra non-byline-author.; De Simone Paolo non-byline-author.; Groenewoud Albert non-byline-author.; Kugler Christiane non-byline-author.; Ohler Linda non-byline-author.; Van Cleemput Johan non-byline-author.; Poncelet Alain Jean non-byline-author.; Sebbag Laurent non-byline-author.; Michel Magali non-byline-author.; Bernard Andrée non-byline-author.; Doesch Andreas non-byline-author.; Livi Ugolino non-byline-author.; Manfredini Valentina non-byline-author.; Brossa-Loidi Vicens non-byline-author.; Segovia-Cubero Javier non-byline-author.; Almenar-Bonet Luis non-byline-author.; Saint-Gerons Carmen Segura non-byline-author.; Mohacsi Paul non-byline-author.; Horvath Eva non-byline-author.; Riotto Cheryl non-byline-author.; Parry Gareth non-byline-author.; Firouzi Ashi non-byline-author.; Kozuszko Stella non-byline-author.; Haddad Haissam non-byline-author.; Kaan Annemarie non-byline-author.; Fisher Grant non-byline-author.; Miller Tara non-byline-author.; Flattery Maureen non-byline-author.; Ludrosky Kristin non-byline-author.; Coleman Bernice non-byline-author.; Trammell Jacqueline non-byline-author.; St Clair Katherine non-byline-author.; Kao Andrew non-byline-author.; Molina Maria non-byline-author.; Canales Karyn Ryan non-byline-author.; de Almeida Samira Scalso non-byline-author.; Ayoub Andrea Cotait non-byline-author.; Barone Fernanda non-byline-author.; Harkess Michelle non-byline-author.; Maddicks-Law Joanne non-byline-author.;
• Is Part Of: European journal of cardiovascular nursing. Volume 17:Number 4(2018)
• Page Start: 356
• Page End: 367
• Publication Date: 2018-04
• Subjects: Heart transplantation -- medication adherence -- practice patterns -- adherence assessment; Cardiovascular system -- Diseases -- Nursing -- Periodicals; Cardiovascular Diseases -- nursing -- Periodicals; Cardiology -- Periodicals; Nursing -- Periodicals; Vascular Diseases -- Periodicals; 610.7369105
• DOI: 10.1177/1474515117747577
• Languages: English
• ISSNs: 1474-5151

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.