Changes in Medication Adherence Across the Posttransplant Period in Pediatric Organ Transplant Recipients

ABSTRACT Introduction Limited research has explored immunosuppressant medication adherence over time in pediatric transplant patients, who often struggle with posttransplant regimen adherence, resulting in poor outcomes. Methods This study investigated the longitudinal growth in immunosuppressive me...

Full description

Saved in:
Bibliographic Details
Published in:Clinical transplantation 2024-10, Vol.38 (10), p.e15442-n/a
Main Authors: Killian, Michael O., Little, Callie W., Mayewski, Sonnie E.
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Female
Follow-Up Studies
Graft Rejection - etiology
Graft Rejection - prevention & control
Graft Survival - drug effects
Humans
Immunosuppressive Agents - therapeutic use
immunosuppressive medication
Infant
longitudinal analysis
Longitudinal Studies
Male
medication adherence
Medication Adherence - statistics & numerical data
Organ Transplantation
pediatrics
Postoperative Complications - prevention & control
Prognosis
Retrospective Studies
Risk Factors
Tacrolimus - therapeutic use
Transplant Recipients - statistics & numerical data
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:ABSTRACT Introduction Limited research has explored immunosuppressant medication adherence over time in pediatric transplant patients, who often struggle with posttransplant regimen adherence, resulting in poor outcomes. Methods This study investigated the longitudinal growth in immunosuppressive medication levels following transplantation. Medication level variability index (MLVI) scores from tacrolimus blood levels of pediatric organ transplant recipients at a major medical center were analyzed. Linear mixed effect models (LMEM) assessed individual MLVI change trajectories and predictors of growth, exploring both linear and curvilinear growth patterns posttransplant. Results A sample of 181 patients with at least 4 years of MLVI data were analyzed. Growth curve modeling identified the cubic model as the best fit for the quarterly MLVI values, which significantly decreased within the first 2 years posttransplant before stabilizing. Gender significantly predicted MLVI change, with females showing greater MLVI decreases, while age at transplant did not significantly predict changes. Significant variation in MLVI among individual patients was found in all models. Conclusions The study demonstrated a significant decrease in MLVI values over time, indicating improved medication adherence in pediatric transplant patients, with females exhibiting more adherent growth patterns than males. Future research should aim to identify pediatric patients at high risk of nonadherence.
ISSN:0902-0063
1399-0012
1399-0012
DOI:10.1111/ctr.15442