Growing pains: non-adherence with the immunosuppressive regimen in adolescent transplant recipients.
One-year graft and patient survival are better in adolescent transplant recipients (age 11-19 years) than in younger (age < 11 years) pediatric transplant recipients. However, several groups found that long-term outcomes (> i.e. 5 year post-transplant) in the adolescent age group are significantly worse than in younger transplant recipients. A behavioral factor that could explain an important part of the poorer clinical outcome in adolescent transplant recipients is non-compliance with medication taking. Adolescents, like all organ transplant recipients irrespective of their age, must adhere to a life-long immunosuppressive regimen in addition to other aspects of their therapeutic regimen. Therefore, adolescent transplant recipients, as all transplant patients, should be regarded as a chronically ill patient population in whom behavioral and psychosocial management is equally important as state-of-the-art medical management. This paper provides an overview of the current knowledge on prevalence, clinical consequences, and risk-factors for non-compliance with the immunosuppressive regimen in adolescent transplant recipients and offers some suggestions for adolescent-tailored interventions to improve medication adherence.
Dobbels
Fabienne
F
Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium.
Van Damme-Lombaert
Rita
R
Vanhaecke
Johan
J
De Geest
Sabina
S
D000293:Adolescent; D006084:Graft Rejection / Q000523:psychology; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology; D010353:Patient Education as Topic; D012307:Risk Factors; D012944:Social Support; D019737:Transplants; D016896:Treatment Outcome; D016312:Treatment Refusal / Q000523:psychology / Q000706:statistics & numerical data
D007166:Immunosuppressive Agents