Publication en vedette dans Journal of Pediatric Transplantation : Bethany J. Foster

Le PRDTC est heureux de souligner l’article intitulé « Care processes and structures associated with higher medication adherence in adolescent and young adult transplant recipients » publié dans Journal of Pediatric Transplantation, dans lequel figurent Bethany J. Foster, Ruth Sapir-Pichhadze, Héloïse Cardinal, Tom Blydt-Hansen, Lee Anne Tibbles, Lorraine Hamiwka, Simon Urschel, Patricia Birk, Jennifer Harrison, Veronique Phan, Upton Allen et Seema Mital, tous chercheurs au PRDTC. Notre coordonnatrice à la recherche Katie Bain s’est entretenue avec Bethany pour connaître l’impact du PRDTC sur sa recherche :

Comment pensez-vous que la recherche fera progresser le domaine ?

Il s’agit de la première étude à inclure des centres pédiatriques et adultes et à saisir les différences de processus et de structures de soins entre les deux. Nous avons identifié les caractéristiques de la prestation des soins qui favorisent une meilleure adhésion, de sorte que ces informations pourraient être utilisées pour optimiser les soins afin d’améliorer l’adhésion. Les interventions seraient simples.

Comment le PRDTC a-t-il contribué à initier ce travail ?

Le PRDTC a financé ce travail. C’était l’un des six projets initiaux. Il n’aurait pas vu le jour sans le PRDTC.

Résumé (en anglais)

Background: We aimed to identify care processes and structures that were independently associated with higher medication adherence among young transplant recipients.

Methods: We conducted a prospective, observational cohort study of 270 prevalent kidney, liver, and heart transplant recipients 14-25 years old. Patients were ≥3 months post-transplant, ≥2 months post-discharge, and followed in one of 14 pediatric or 14 adult transplant programs in Canada. Patients were enrolled between June 2015 and March 2018 and followed for 6 months. Adherence was assessed at baseline, 3, and 6 months using the BAASIS© self-report tool. Patients were classified as adherent if no doses were missed in the prior 4 weeks. Transplant program directors and nurses completed questionnaires regarding care organization and processes.

Results: Of the 270 participants, 99 were followed in pediatric programs and 171 in adult programs. Median age was 20.3 years, and median time since transplant was 5 years. At baseline, 71.5% were adherent. Multivariable mixed effects logistic regression models with program as a random effect identified two program-level factors as independently associated with better adherence: minimum number of prescribed blood draws per year for those >3 years post-transplant (per 1 additional) (OR 1.12 [95% CI 1.00, 1.26]; p = .047), and average time nurses spend with patients in clinic (per 5 additional minutes) (OR 1.15 [1.03, 1.29]; p = .017).

Conclusion: Program-level factors including protocols with a greater frequency of routine blood testing and more nurse time with patients were associated with better medication adherence. This suggests that interventions at the program level may support better adherence.

Lisez l’article complet « Care processes and structures associated with higher medication adherence in adolescent and young adult transplant recipients » (en anglais)
À propos du Journal of Pediatric Transplantation

Pediatric Transplantation est le seul journal consacré à la transplantation chez les nourrissons, les enfants et les adolescents. La revue vise à faire progresser la science et la pratique de la transplantation chez les enfants dans le monde entier, en offrant un forum qui met en lumière les avancées les plus récentes de la science clinique et fondamentale dans ce domaine.

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