Improving Medication Adherence in Kidney Transplant Recipients Through Educational Intervention and Monitoring: A Randomized Clinical Trial

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2026-09-01 Epub Date: 2026-06-18 DOI:10.1016/j.transproceed.2026.05.011

Carolina Heinrich de Oliveira, Anita Schweig, Beatriz Paganin Gonçalves, Carolina Andrade Bissani, Maria Antônia Peres Saldanha, Alessandra Dalla Rosa Santini, Evellinne Riva, Helena Dai Prá Maestri, Rafael Vianna Behr, Leonardo Viliano Kroth

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Abstract

Background

Kidney graft survival after transplantation is highly dependent on continuous adherence to immunosuppressive therapy. Poor adherence is a significant cause of graft loss, and educational interventions to optimize care have been proposed. We evaluated the effect of standardized educational interventions on knowledge, adherence, and clinical outcomes in kidney transplant recipients.

Methods

In this randomized clinical trial including 59 patients, the intervention group (n = 31) received 2 health education sessions (video, booklet, and oral explanations), while the control group (n = 28) received only routine discharge guidance. Patients’ knowledge was assessed using a questionnaire before and after the intervention, and adherence was measured with the Basel Assessment of Adherence to Immunosuppressive Medication Scale (BAASIS). Clinical outcomes were monitored for 12 months.

Results

Educational interventions had a highly significant impact on patients’ knowledge. At 1 week after discharge, the intervention group scored significantly higher than the control group (7.5 vs 5.1; P < .001). Adherence assessed by BAASIS at 6 months was statistically similar in the 2 groups (45.2% vs 39.3%; P = .697). No statistically significant between-group differences were observed in rejection rates, infections, or survival during the first year.

Conclusion

Educational interventions proved to be an effective strategy to increase patients’ knowledge about post-transplantation treatment. Although short-term effects on clinical outcomes and adherence were not significant, improved knowledge is crucial to promote long-term adherence.

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通过教育干预和监测提高肾移植受者的药物依从性：一项随机临床试验。

背景：肾移植后的存活高度依赖于免疫抑制治疗的持续坚持。较差的依从性是移植物损失的重要原因，并且已经提出了优化护理的教育干预措施。我们评估了标准化教育干预对肾移植受者的知识、依从性和临床结果的影响。方法：随机临床试验59例患者，干预组（n = 31）接受2次健康教育（视频、宣传册和口头讲解），对照组（n = 28）仅接受常规出院指导。采用干预前后问卷评估患者的知识，采用巴塞尔免疫抑制药物依从性评估量表（basasis）测量依从性。临床结果监测12个月。结果：教育干预对患者的认知有显著影响。出院后1周，干预组得分显著高于对照组（7.5 vs 5.1; P < 0.001）。6个月时basis评估的依从性在两组中具有统计学意义相似（45.2% vs 39.3%; P = 0.697）。在第一年的排异率、感染或存活率方面，组间没有统计学上的显著差异。结论：教育干预是提高患者移植后治疗知识的有效策略。虽然对临床结果和依从性的短期影响并不显著，但提高知识对于促进长期依从性至关重要。

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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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.