Improving adherence to immunosuppression after liver or kidney transplantation in individuals with impairments in personality functioning – A randomized controlled single center feasibility study
IntroductionAlthough adherence to immunosuppressive medication is the key factor for long-term graft survival today, 20–70% of transplant recipients are non-adherent to their immunosuppressive medication.ObjectiveA prospective, randomized, controlled single-center feasibility study was designed to e...
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Psychology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyg.2023.1150548/full |
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| author | Jolana Wagner-Skacel Jolana Wagner-Skacel Nadja Fink Nadja Fink Judith Kahn Judith Kahn Nina Dalkner Emanuel Jauk Susanne Bengesser Marco Mairinger Gerhard Schüssler Christoph Pieh Vanessa Stadlbauer Alexander H. Kirsch Alexander H. Kirsch Sabine Zitta Sabine Zitta Alexander R. Rosenkranz Alexander R. Rosenkranz Peter Fickert Peter Fickert Peter Schemmer Peter Schemmer |
| author_facet | Jolana Wagner-Skacel Jolana Wagner-Skacel Nadja Fink Nadja Fink Judith Kahn Judith Kahn Nina Dalkner Emanuel Jauk Susanne Bengesser Marco Mairinger Gerhard Schüssler Christoph Pieh Vanessa Stadlbauer Alexander H. Kirsch Alexander H. Kirsch Sabine Zitta Sabine Zitta Alexander R. Rosenkranz Alexander R. Rosenkranz Peter Fickert Peter Fickert Peter Schemmer Peter Schemmer |
| author_sort | Jolana Wagner-Skacel |
| collection | DOAJ |
| description | IntroductionAlthough adherence to immunosuppressive medication is the key factor for long-term graft survival today, 20–70% of transplant recipients are non-adherent to their immunosuppressive medication.ObjectiveA prospective, randomized, controlled single-center feasibility study was designed to evaluate the impact of a step guided multicomponent interprofessional intervention program for patients after kidney or liver transplantation on adherence to their immunosuppressive medication in daily clinical practice.Materials and methodsThe intervention consisted of group therapy and daily training as well as individual sessions in a step guided approach. The primary endpoint of the study was adherence to immunosuppression as assessed with the “Basel Assessment of Adherence to Immunosuppressive Medications Scale” (BAASIS). The coefficient of variation (CV%) of Tacrolimus (TAC) through levels and the level of personality functioning was a secondary endpoint. We conducted six monthly follow-up visits.ResultsForty-one age- and sex-matched patients [19 females, 58.5 (SD = 10.56) years old, 22 kidney- and 19 liver transplantation] were randomized to the intervention- (N = 21) or control-group (N = 20). No differences between intervention- and control groups were found in the primary endpoint adherence and CV% of TAC. However, in further exploratory analyses, we observed that individuals with higher impairments in personality functioning showed higher CV% of TAC in the controls. The intervention might compensate personality-related susceptibility to poor adherence as evident in CV% of TAC.DiscussionThe results of the feasibility study showed that this intervention program was highly accepted in the clinical setting. The Intervention group could compensate higher CV% of TAC after liver or kidney transplantation in individuals with lower levels of personality functioning and non-adherence.Clinical trial registrationClinicalTrials.gov, identifier NCT04207125. |
| first_indexed | 2024-04-10T05:13:26Z |
| format | Article |
| id | doaj.art-13d80ed651674afca418c9cf29842051 |
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| issn | 1664-1078 |
| language | English |
| last_indexed | 2024-04-10T05:13:26Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Psychology |
| spelling | doaj.art-13d80ed651674afca418c9cf298420512023-03-09T05:27:23ZengFrontiers Media S.A.Frontiers in Psychology1664-10782023-03-011410.3389/fpsyg.2023.11505481150548Improving adherence to immunosuppression after liver or kidney transplantation in individuals with impairments in personality functioning – A randomized controlled single center feasibility studyJolana Wagner-Skacel0Jolana Wagner-Skacel1Nadja Fink2Nadja Fink3Judith Kahn4Judith Kahn5Nina Dalkner6Emanuel Jauk7Susanne Bengesser8Marco Mairinger9Gerhard Schüssler10Christoph Pieh11Vanessa Stadlbauer12Alexander H. Kirsch13Alexander H. Kirsch14Sabine Zitta15Sabine Zitta16Alexander R. Rosenkranz17Alexander R. Rosenkranz18Peter Fickert19Peter Fickert20Peter Schemmer21Peter Schemmer22Department of Medical Psychology, Psychosomatics, and Psychotherapy, Medical University of Graz, Graz, AustriaUniversity Transplant Center Graz, Medical University of Graz, Graz, AustriaUniversity Transplant Center Graz, Medical University of Graz, Graz, AustriaDivision of Abdominal, Visceral, and Transplant Surgery, Department of Surgery, Medical University of Graz, Graz, AustriaUniversity Transplant Center Graz, Medical University of Graz, Graz, AustriaDivision of Abdominal, Visceral, and Transplant Surgery, Department of Surgery, Medical University of Graz, Graz, AustriaDepartment of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, AustriaDepartment of Medical Psychology, Psychosomatics, and Psychotherapy, Medical University of Graz, Graz, AustriaDepartment of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, AustriaDepartment of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, AustriaDepartment of Medical Psychology, Psychosomatics, and Psychotherapy, Medical University of Graz, Graz, AustriaDepartment of Psychosomatic Medicine, University for Continuing Education Krems, Krems an der Donau, AustriaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, AustriaUniversity Transplant Center Graz, Medical University of Graz, Graz, AustriaDivision of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, AustriaUniversity Transplant Center Graz, Medical University of Graz, Graz, AustriaDivision of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, AustriaUniversity Transplant Center Graz, Medical University of Graz, Graz, AustriaDivision of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, AustriaUniversity Transplant Center Graz, Medical University of Graz, Graz, AustriaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, AustriaUniversity Transplant Center Graz, Medical University of Graz, Graz, AustriaDivision of Abdominal, Visceral, and Transplant Surgery, Department of Surgery, Medical University of Graz, Graz, AustriaIntroductionAlthough adherence to immunosuppressive medication is the key factor for long-term graft survival today, 20–70% of transplant recipients are non-adherent to their immunosuppressive medication.ObjectiveA prospective, randomized, controlled single-center feasibility study was designed to evaluate the impact of a step guided multicomponent interprofessional intervention program for patients after kidney or liver transplantation on adherence to their immunosuppressive medication in daily clinical practice.Materials and methodsThe intervention consisted of group therapy and daily training as well as individual sessions in a step guided approach. The primary endpoint of the study was adherence to immunosuppression as assessed with the “Basel Assessment of Adherence to Immunosuppressive Medications Scale” (BAASIS). The coefficient of variation (CV%) of Tacrolimus (TAC) through levels and the level of personality functioning was a secondary endpoint. We conducted six monthly follow-up visits.ResultsForty-one age- and sex-matched patients [19 females, 58.5 (SD = 10.56) years old, 22 kidney- and 19 liver transplantation] were randomized to the intervention- (N = 21) or control-group (N = 20). No differences between intervention- and control groups were found in the primary endpoint adherence and CV% of TAC. However, in further exploratory analyses, we observed that individuals with higher impairments in personality functioning showed higher CV% of TAC in the controls. The intervention might compensate personality-related susceptibility to poor adherence as evident in CV% of TAC.DiscussionThe results of the feasibility study showed that this intervention program was highly accepted in the clinical setting. The Intervention group could compensate higher CV% of TAC after liver or kidney transplantation in individuals with lower levels of personality functioning and non-adherence.Clinical trial registrationClinicalTrials.gov, identifier NCT04207125.https://www.frontiersin.org/articles/10.3389/fpsyg.2023.1150548/fullliver transplantationkidney transplantationadherenceimmunosuppressionmultilevel intervention |
| spellingShingle | Jolana Wagner-Skacel Jolana Wagner-Skacel Nadja Fink Nadja Fink Judith Kahn Judith Kahn Nina Dalkner Emanuel Jauk Susanne Bengesser Marco Mairinger Gerhard Schüssler Christoph Pieh Vanessa Stadlbauer Alexander H. Kirsch Alexander H. Kirsch Sabine Zitta Sabine Zitta Alexander R. Rosenkranz Alexander R. Rosenkranz Peter Fickert Peter Fickert Peter Schemmer Peter Schemmer Improving adherence to immunosuppression after liver or kidney transplantation in individuals with impairments in personality functioning – A randomized controlled single center feasibility study Frontiers in Psychology liver transplantation kidney transplantation adherence immunosuppression multilevel intervention |
| title | Improving adherence to immunosuppression after liver or kidney transplantation in individuals with impairments in personality functioning – A randomized controlled single center feasibility study |
| title_full | Improving adherence to immunosuppression after liver or kidney transplantation in individuals with impairments in personality functioning – A randomized controlled single center feasibility study |
| title_fullStr | Improving adherence to immunosuppression after liver or kidney transplantation in individuals with impairments in personality functioning – A randomized controlled single center feasibility study |
| title_full_unstemmed | Improving adherence to immunosuppression after liver or kidney transplantation in individuals with impairments in personality functioning – A randomized controlled single center feasibility study |
| title_short | Improving adherence to immunosuppression after liver or kidney transplantation in individuals with impairments in personality functioning – A randomized controlled single center feasibility study |
| title_sort | improving adherence to immunosuppression after liver or kidney transplantation in individuals with impairments in personality functioning a randomized controlled single center feasibility study |
| topic | liver transplantation kidney transplantation adherence immunosuppression multilevel intervention |
| url | https://www.frontiersin.org/articles/10.3389/fpsyg.2023.1150548/full |
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