Significance of patient self-monitoring for long-term outcomes after lung transplantation

• Published in: Clinical transplantation 2010-09, Vol.24 (5), p.709-716
• Main Authors: Kugler, Christiane, Gottlieb, Jens, Dierich, Martin, Haverich, Axel, Strueber, Martin, Welte, Tobias, Simon, Andre
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Cross-Sectional Studies; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft Rejection - diagnosis; Humans; Lung Transplantation; Male; Medical sciences; Middle Aged; Monitoring, Ambulatory; non-adherence; Outcome Assessment (Health Care); Patient Compliance; Postoperative Complications; Retrospective Studies; Self Care; self-monitoring; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue, organ and graft immunology; Young Adult
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/j.1399-0012.2009.01197.x

Kugler C, Gottlieb J, Dierich M, Haverich A, Strueber M, Welte T, Simon A. Significance of patient self‐monitoring for long‐term outcomes after lung transplantation.
Clin Transplant 2009 DOI: 10.1111/j.1399‐0012.2009.01197.x
© 2009 John Wiley & Sons A/S. :  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