Practice patterns to improve pre and post-transplant medication adherence in heart transplant centres: a secondary data analysis of the international BRIGHT study. (1st 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; Crespo-Leiro, Maria G; Cupples, Sandra; De Simone, Paolo; Groenewoud, Albert; Kugler, Christiane; Ohler, Linda; Van Cleemput, Johan; Poncelet, Alain Jean; Sebbag, Laurent; Michel, Magali; Bernard, Andrée; Doesch, Andreas; Livi, Ugolino; Manfredini, Valentina; Brossa-Loidi, Vicens; Segovia-Cubero, Javier; Almenar-Bonet, Luis; Saint-Gerons, Carmen Segura; Mohacsi, Paul; Horvath, Eva; Riotto, Cheryl; Parry, Gareth; Firouzi, Ashi; Kozuszko, Stella; Haddad, Haissam; Kaan, Annemarie; Fisher, Grant; Miller, Tara; Flattery, Maureen; Ludrosky, Kristin; Coleman, Bernice; Trammell, Jacqueline; St Clair, Katherine; Kao, Andrew; Molina, Maria; Canales, Karyn Ryan; de Almeida, Samira Scalso; Ayoub, Andrea Cotait; Barone, Fernanda; Harkess, Michelle; Maddicks-Law, Joanne;
• Editors: King-Shier, Kathryn; Ski, Chantal; Fitzsimons, Donna
• Is Part Of: European journal of cardiovascular nursing. Volume 17:Number 4(2018)
• Page Start: 356
• Page End: 367
• Publication Date: 2018-04-01
• 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

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.