Nonadherence to immunosuppressives and treatment in kidney transplant: Adhere Brazil Study
Rev. saúde pública (Online)
;
55: 33, 2021. tab, graf
Article
in English
| LILACS, BBO
| ID: biblio-1252116
ABSTRACT
ABSTRACT OBJECTIVE To estimate the prevalence and variability of nonadherence to immunosuppressives and nonpharmacological treatment across kidney transplantation centers and two health access-disparate regions in Brazil. METHODS In a cross-sectional design, a random multistage sample of 1,105 patients was included, based on center transplantation activity (low/moderate/high) and region (R1 North/Northeast/Mid-West; and R2 South/Southeast). Nonadherence to immunosuppressives (implementation phase) was assessed using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS)©. Self-report questionnaires assessed nonadherence to physical activity, smoking cessation, alcohol intake, and appointment keeping. We compared regions using the adjusted-χ2 or t-test. RESULTS Most patients were men (58.5%), white (51.4%), and had a mean age of 47.5 (SD = 12.6) years. Regarding kidney transplantation centers, 75.9% were from R2 and 38.2% had low activity. The patients in R2 were older, white-majority, had more frequently steady partners, and received peritoneal dialysis. Nonadherence to immunosuppressives ranged from 11-65.2%; 44.5-90% to physical activity; 0-23.7% to appointment keeping; and 0-14% to smoking cessation. The total prevalence of nonadherence and by region (R1 versus R2) were for immunosuppressives, 39.7% (44.9% versus 38.1%, p = 0.18); for smoking, 3.9% (1% versus 5%, p < 0.001); for physical activity, 69.1% (71% versus 69%, p = 0.48); for appointment keeping, 13% (12.7% versus 12%, p = 0.77); and for alcohol consumption, 0%. CONCLUSION Despite differences among centers and high variability, only the nonadherence to smoking cessation was higher in the region with greater access to kidney transplantation. We suppose that differences in healthcare access may have been overcome by other positive aspects of the post kidney transplantation treatment.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Kidney Transplantation
Type of study:
Observational study
/
Prevalence study
/
Risk factors
Limits:
Female
/
Humans
/
Male
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Rev. saúde pública (Online)
Journal subject:
Sa£de P£blica
Year:
2021
Type:
Article
Affiliation country:
Brazil
/
Switzerland
Institution/Affiliation country:
Universidade Federal de Juiz de Fora/BR
/
University of Basel/CH
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