Nonadherence to immunosuppressives and treatment in kidney transplant: ADHERE BRAZIL Study
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng por |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/186704 |
Resumo: | 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. |
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Nonadherence to immunosuppressives and treatment in kidney transplant: ADHERE BRAZIL StudyPatient nonadherenceMedication nonadherenceKidney transplantMulticenter studyHealth services accessibilityOBJECTIVE 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.Universidade de São Paulo. Faculdade de Saúde Pública2021-05-31info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdftext/xmlhttps://www.revistas.usp.br/rsp/article/view/18670410.11606/s1518-8787.2021055002894Revista de Saúde Pública; Vol. 55 (2021); 33Revista de Saúde Pública; Vol. 55 (2021); 33Revista de Saúde Pública; v. 55 (2021); 331518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPengporhttps://www.revistas.usp.br/rsp/article/view/186704/172289https://www.revistas.usp.br/rsp/article/view/186704/172288Copyright (c) 2021 Elisa Oliveira Marsicano-Souza, Fernando Colugnati, Sabina De Geest, Helady Sanders-Pinheirohttp://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessMarsicano-Souza, Elisa OliveiraColugnati, FernandoDe Geest, SabinaSanders-Pinheiro, Helady2021-06-09T18:55:00Zoai:revistas.usp.br:article/186704Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2021-06-09T18:55Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Nonadherence to immunosuppressives and treatment in kidney transplant: ADHERE BRAZIL Study |
title |
Nonadherence to immunosuppressives and treatment in kidney transplant: ADHERE BRAZIL Study |
spellingShingle |
Nonadherence to immunosuppressives and treatment in kidney transplant: ADHERE BRAZIL Study Marsicano-Souza, Elisa Oliveira Patient nonadherence Medication nonadherence Kidney transplant Multicenter study Health services accessibility |
title_short |
Nonadherence to immunosuppressives and treatment in kidney transplant: ADHERE BRAZIL Study |
title_full |
Nonadherence to immunosuppressives and treatment in kidney transplant: ADHERE BRAZIL Study |
title_fullStr |
Nonadherence to immunosuppressives and treatment in kidney transplant: ADHERE BRAZIL Study |
title_full_unstemmed |
Nonadherence to immunosuppressives and treatment in kidney transplant: ADHERE BRAZIL Study |
title_sort |
Nonadherence to immunosuppressives and treatment in kidney transplant: ADHERE BRAZIL Study |
author |
Marsicano-Souza, Elisa Oliveira |
author_facet |
Marsicano-Souza, Elisa Oliveira Colugnati, Fernando De Geest, Sabina Sanders-Pinheiro, Helady |
author_role |
author |
author2 |
Colugnati, Fernando De Geest, Sabina Sanders-Pinheiro, Helady |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Marsicano-Souza, Elisa Oliveira Colugnati, Fernando De Geest, Sabina Sanders-Pinheiro, Helady |
dc.subject.por.fl_str_mv |
Patient nonadherence Medication nonadherence Kidney transplant Multicenter study Health services accessibility |
topic |
Patient nonadherence Medication nonadherence Kidney transplant Multicenter study Health services accessibility |
description |
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. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-05-31 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/186704 10.11606/s1518-8787.2021055002894 |
url |
https://www.revistas.usp.br/rsp/article/view/186704 |
identifier_str_mv |
10.11606/s1518-8787.2021055002894 |
dc.language.iso.fl_str_mv |
eng por |
language |
eng por |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/186704/172289 https://www.revistas.usp.br/rsp/article/view/186704/172288 |
dc.rights.driver.fl_str_mv |
http://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
http://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf text/xml |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 55 (2021); 33 Revista de Saúde Pública; Vol. 55 (2021); 33 Revista de Saúde Pública; v. 55 (2021); 33 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1800221802001072128 |