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Adherence
Post transplant life is that of any chronic illness and adherence to medications and the medical regime is vital for a good outcome. There are many factors that influence non-adherence and they are not unique to transplant.
They include
- Medication related issues - cost, taste, availability, administration timing, complex regimes, forgetfulness
- Psychological issues - poor coping mechanisms, self image, loss of normality, peer pressure
- Developmental stage - teenagers and young adults are particularity vulnerable
- Family dysfunction - economic stressors, poor social support
- Cognitive functioning of patient and family - educational level, learning difficulties
- Healthcare availabilty
- Healthcare-patient continuity and relationships
Unfortunately there are few tools to measure adherence reliably and often preconceived views of likely adherent or non-adherent families are wrong. Even in this digital age and of tracking "apps" it is easy to fool parents and healthcare staff.
Methods to reduce non-adherence are time consuming and of questionable efficacy. Ensuring the medical regimes (medications, hospital visits) are tailored to the individual family is common sense. Medications should be reviewed often and those that have become unnecessary removed. Long acting medications should be used where possible. Education is the main weapon - starting from early teenage years using age appropriate materials through a comprehensive so called "transition" progam.
Further Reading
- The psychosocial organ transplant assessment: A call to action. Pediatric Transplantation. 2023;27:e14453
Authors: Richard Kirk, Nathanya BaezHernandez
Updated: 20 June 2023
Updated: 20 June 2023