title: Significance of patient self-monitoring for long-term outcomes after lung transplantation.
abstract: BACKGROUND
  Lung transplant (LTx) recipients' adherence to regular self-monitoring of lung function (SMLF) is important in maintaining health. This study investigated patients' behavior based on electronic monitoring (EM) and compared these findings with self-reported data.
  
  
  METHODS
  This single-center study included 269 patients following LTx. Patients reported on adherence regarding SMLF, and data were compared to electronically stored measurements for the last three months prior to self-reporting.
  
  
  RESULTS
  Non-adherence was 59.4% based on EM for a total of 22,052 measurements performed. Main reported reasons for non-adherence were forgetfulness (22%), lack of time (19%), and good self-perception of health status (19%). Determinants for non-adherence were patients constraining beliefs (p ≤ 0.0001), low perceived support from the transplant center (p ≤ 0.008), a history of infections (p ≤ 0.014) and rejections (p ≤ 0.043), and bronchiolitis obliterans (p ≤ 0.006). Multiple logistic regression revealed low-perceived support from the transplant center (OR 3.22; 95% CI 1.32-7.83; p < 0.01), and lack of support from patient organizations (OR 2.19; 95% CI 1.02-4.72; p < 0.04) as independent predictors for non-adherence.
  
  
  CONCLUSIONS
  LTx recipients had some difficulties maintaining SMLF on a daily basis. Non-adherence regarding lung function monitoring may provide a clinically relevant estimate of suspect cases for critical events impacting outcomes after LTx.
authors.affiliation: Division of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Thoracic Transplant Program, Hannover Medical School, Hannover, Germany. kugler.christiane@mh-hannover.de
authors.forename: Christiane
authors.initials: C
authors.lastname: Kugler
authors.forename: Jens
authors.initials: J
authors.lastname: Gottlieb
authors.forename: Martin
authors.initials: M
authors.lastname: Dierich
authors.forename: Axel
authors.initials: A
authors.lastname: Haverich
authors.forename: Martin
authors.initials: M
authors.lastname: Strueber
authors.forename: Tobias
authors.initials: T
authors.lastname: Welte
authors.forename: Andre
authors.initials: A
authors.lastname: Simon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis*; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D011183:Postoperative Complications; D012189:Retrospective Studies; D012648:Self Care; D055815:Young Adult