Association between the Stanford Integrated Psychosocial Assessment for Transplant and 1-year medication nonadherence after living kidney transplantation.
Kosuke Takano, Sayaka Kobayashi, Hidehiro Oshibuchi, Junko Tsutsui, Satoko Ito, Rumiko Kamba, Rie Akaho, Katsuji Nishimura
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Abstract
Aim: This study investigated the association between the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) and medication nonadherence (MNA) in living kidney transplantation (LKT) recipients.
Methods: This single-center prospective cohort study included 132 LKT recipients at Tokyo Women's Medical University Hospital between July 2020 and July 2021. Pretransplant psychosocial evaluations used the Japanese version of the SIPAT (SIPAT-J), and MNA was assessed 1 year posttransplant using the Basel Assessment of Adherence to Immunosuppressive Medication Scale© (BAASIS© ). Participants completing both SIPAT-J and BAASIS© evaluations (n = 111) were analyzed. Multivariable logistic regression analysis was conducted to examine the relationship between SIPAT scores and MNA, adjusting for age, sex, and employment status.
Results: Participants had a median age of 52 years; 63.1% were male. MNA was observed in 39.6% of recipients, primarily due to timing deviations (34.2%) and missed doses (11.7%). Higher SIPAT D (Lifestyle and Effect of Substance Use) scores were significantly associated with MNA (odds ratio = 1.304, 95% confidence interval = 1.006-1.692, P = 0.045). Other SIPAT subscales and total scores were not significantly associated with MNA.
Conclusion: To our knowledge, this is the first study to investigate the association between SIPAT and MNA in LKT recipients. MNA remains prevalent 1 year post-LKT, with lifestyle and substance use factors (SIPAT D) showing a significant association. These results underscore the importance of conducting comprehensive psychosocial evaluations, including assessments of lifestyle and substance use, prior to transplantation. Such evaluations may facilitate the identification of at-risk individuals and enable the implementation of targeted interventions to improve medication adherence and posttransplant outcomes.
斯坦福移植综合社会心理评估与活体肾移植后1年药物不依从的关系。
目的：本研究探讨活体肾移植（LKT）受者斯坦福移植综合心理社会评估（SIPAT）与药物依从性（MNA）之间的关系。方法：这项单中心前瞻性队列研究纳入了2020年7月至2021年7月在东京女子医科大学医院接受LKT治疗的132名患者。移植前社会心理评估采用日本版SIPAT (SIPAT- j)，移植后1年采用巴塞尔免疫抑制药物依从性评估量表©（basasis©）评估MNA。同时完成SIPAT-J和BAASIS©评估的参与者（n = 111）进行分析。采用多变量logistic回归分析来检验SIPAT分数与MNA之间的关系，调整了年龄、性别和就业状况。结果：参与者的中位年龄为52岁；63.1%为男性。39.6%的受者观察到MNA，主要是由于时间偏差（34.2%）和错过剂量（11.7%）。较高的SIPAT D（生活方式和物质使用的影响）评分与MNA显著相关（优势比= 1.304,95%可信区间= 1.006-1.692,P = 0.045）。其他SIPAT量表和总分与MNA无显著相关。结论：据我们所知，这是第一个调查LKT受者SIPAT和MNA之间关系的研究。MNA在lkt后1年仍然普遍存在，生活方式和物质使用因素（SIPAT D）显示出显著的相关性。这些结果强调了在移植前进行全面的社会心理评估的重要性，包括对生活方式和药物使用的评估。这种评估可能有助于识别高危个体，并能够实施有针对性的干预措施，以改善药物依从性和移植后的结果。
本文章由计算机程序翻译，如有差异，请以英文原文为准。
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