Lei Dong, Keke Lin, Shan Liu, Hongxia Liu, Jia Liu
{"title":"肾移植受者免疫抑制药物依从性的轨迹：一项2年前瞻性队列研究","authors":"Lei Dong, Keke Lin, Shan Liu, Hongxia Liu, Jia Liu","doi":"10.1111/ctr.70280","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Immunosuppressive medication (IM) adherence, a dynamic and time-dependent behavior, is typically suboptimal among kidney transplant recipients (KTRs) and severely impacts their prognosis. Longitudinal data regarding the temporal trajectories of medication adherence are important for devising targeted intervention strategies.</p>\n </section>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>To identify the trajectories of IM adherence in KTRs over the 2 years post transplantation.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Two hundred and twenty-two KTRs were recruited from a tertiary care hospital in China between May 2020 and February 2022. Data were collected at 3-, 6-, 12-, and 24-month post kidney transplantation. IM adherence was defined according to the BAASIS scale. A group-based trajectory model was used to depict and identify distinct trajectories. Univariate analysis and multinomial logistic regression were conducted to evaluate the association between baseline factors and membership in different trajectory groups.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The prevalence of medication non-adherence at 3, 6, 12, and 24 months after transplantation was 10.8%, 9.9%, 11.7%, and 22.1%, respectively. Three adherence trajectories were identified, including the “consistent adherence” (65.5%), “high start and decreasing adherence” (28.0%), and “increasing adherence” (6.6%) trajectory group. The critical transition point, as the 6-month time point after transplantation, in adherence dynamics was identified. Recipients experiencing decreasing adherence trajectories were possibly younger, received a technical/high school education, and lived alone.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Distinct trajectories of medication adherence among KTRs were identified during the 2-year post-transplantation period. A previously unrecognized adherence trajectory-the “increasing adherence” trajectory and the critical transition point in adherence dynamics was identified, particularly highlighting the 6-month post transplantation period as a pivotal intervention window.</p>\n </section>\n </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Trajectories of Immunosuppressive Medication Adherence Among Kidney Transplant Recipients: A 2-Year Prospective Cohort Study\",\"authors\":\"Lei Dong, Keke Lin, Shan Liu, Hongxia Liu, Jia Liu\",\"doi\":\"10.1111/ctr.70280\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Immunosuppressive medication (IM) adherence, a dynamic and time-dependent behavior, is typically suboptimal among kidney transplant recipients (KTRs) and severely impacts their prognosis. Longitudinal data regarding the temporal trajectories of medication adherence are important for devising targeted intervention strategies.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>To identify the trajectories of IM adherence in KTRs over the 2 years post transplantation.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Two hundred and twenty-two KTRs were recruited from a tertiary care hospital in China between May 2020 and February 2022. Data were collected at 3-, 6-, 12-, and 24-month post kidney transplantation. IM adherence was defined according to the BAASIS scale. A group-based trajectory model was used to depict and identify distinct trajectories. Univariate analysis and multinomial logistic regression were conducted to evaluate the association between baseline factors and membership in different trajectory groups.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The prevalence of medication non-adherence at 3, 6, 12, and 24 months after transplantation was 10.8%, 9.9%, 11.7%, and 22.1%, respectively. Three adherence trajectories were identified, including the “consistent adherence” (65.5%), “high start and decreasing adherence” (28.0%), and “increasing adherence” (6.6%) trajectory group. The critical transition point, as the 6-month time point after transplantation, in adherence dynamics was identified. Recipients experiencing decreasing adherence trajectories were possibly younger, received a technical/high school education, and lived alone.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Distinct trajectories of medication adherence among KTRs were identified during the 2-year post-transplantation period. 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Trajectories of Immunosuppressive Medication Adherence Among Kidney Transplant Recipients: A 2-Year Prospective Cohort Study
Background
Immunosuppressive medication (IM) adherence, a dynamic and time-dependent behavior, is typically suboptimal among kidney transplant recipients (KTRs) and severely impacts their prognosis. Longitudinal data regarding the temporal trajectories of medication adherence are important for devising targeted intervention strategies.
Objective
To identify the trajectories of IM adherence in KTRs over the 2 years post transplantation.
Methods
Two hundred and twenty-two KTRs were recruited from a tertiary care hospital in China between May 2020 and February 2022. Data were collected at 3-, 6-, 12-, and 24-month post kidney transplantation. IM adherence was defined according to the BAASIS scale. A group-based trajectory model was used to depict and identify distinct trajectories. Univariate analysis and multinomial logistic regression were conducted to evaluate the association between baseline factors and membership in different trajectory groups.
Results
The prevalence of medication non-adherence at 3, 6, 12, and 24 months after transplantation was 10.8%, 9.9%, 11.7%, and 22.1%, respectively. Three adherence trajectories were identified, including the “consistent adherence” (65.5%), “high start and decreasing adherence” (28.0%), and “increasing adherence” (6.6%) trajectory group. The critical transition point, as the 6-month time point after transplantation, in adherence dynamics was identified. Recipients experiencing decreasing adherence trajectories were possibly younger, received a technical/high school education, and lived alone.
Conclusions
Distinct trajectories of medication adherence among KTRs were identified during the 2-year post-transplantation period. A previously unrecognized adherence trajectory-the “increasing adherence” trajectory and the critical transition point in adherence dynamics was identified, particularly highlighting the 6-month post transplantation period as a pivotal intervention window.
期刊介绍：
Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored.
Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include:
Immunology and immunosuppression;
Patient preparation;
Social, ethical, and psychological issues;
Complications, short- and long-term results;
Artificial organs;
Donation and preservation of organ and tissue;
Translational studies;
Advances in tissue typing;
Updates on transplant pathology;.
Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries.
Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.
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