• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Systematic Reviews >Interventions to increase adherence in patients taking immunosuppressive drugs after kidney transplantation: a systematic review of controlled trials
【24h】

Interventions to increase adherence in patients taking immunosuppressive drugs after kidney transplantation: a systematic review of controlled trials

机译：肾脏移植后采取免疫抑制药物的患者增加依从性的干预措施：对照试验的系统评价

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Immunosuppressive drugs have to be taken through the whole duration of kidney transplant survival to avoid rejection. Low adherence can increase the risk of allograft rejection. The objective was to evaluate the effectiveness of adherence-enhancing interventions (AEI) in kidney transplantation recipients taking immunosuppressive drugs. A search was performed in Medline, Embase, CINAHL, and PsycINFO. The search was performed in May 2016. We included comparative studies on AEI for kidney transplant recipients taking immunosuppressive drugs. The primary outcome was medication adherence. All identified articles were screened according to the predefined inclusion criteria. The risk of bias was assessed with the Cochrane risk of bias tool. Study selection and risk of bias assessment were performed by two reviewers independently. Data were extracted in standardized tables. Data extraction was verified by a second reviewer. All discrepancies were resolved through discussion. Data were synthesized in a structured narrative way. There is no registered or published protocol for this systematic review. We identified 12 studies. The number of participants ranged from 24 to 1830. Nine studies included adults, two children, and one adults and children. Risk of bias was high. The main reasons for high risk of bias were inadequate allocation sequence (confounding) and that studies were not blinded. Eleven studies evaluated AEI consisting of educational and/or behavioral components. All these studies showed an effect direction in favor of the intervention. Intervention effect was only moderate. Most adherence measures in studies on educational and behavioral interventions showed statistically significant differences. Studies that combined educational and behavioral intervention components showed larger effects. All studies that were statistically significant were multimodal. Studies that included an individualized component and more intensive interventions showed larger effects. One study evaluated a reminder system. Effect size was not reported. This study showed no statistical significant difference (p?>?0.05). Educational and behavioral AEI can increase adherence. In particular, multimodal and individualized interventions seem promising. However, because of the small effect, the high risk of bias, and the invalidity of adherence measures, the actual benefit of adherence interventions for an unselected patient population (i.e., including also adherent patients) seems limited. No conclusion is possible for interventions combining adherence-enhancing components that address intentional (behavioral) as well as unintentional adherence (reminder).
机译：在肾脏移植生存的整个过程中都必须服用免疫抑制药物，以避免排斥反应。依从性低会增加同种异体移植排斥的风险。目的是评估在采用免疫抑制药物的肾移植接受者中增强依从性干预措施（AEI）的有效性。在Medline，Embase，CINAHL和PsycINFO中进行了搜索。该搜索于2016年5月进行。我们纳入了针对接受免疫抑制药物的肾移植受者的AEI的比较研究。主要结果是药物依从性。根据预定义的纳入标准筛选所有鉴定出的文章。使用Cochrane偏倚风险工具评估了偏倚风险。研究的选择和偏倚评估的风险由两名审稿人独立进行。将数据提取到标准化表格中。数据提取由第二位审阅者验证。通过讨论解决了所有差异。数据以结构化叙事方式进行合成。没有针对该系统评价的注册或发布协议。我们确定了12个研究。参与者的数量从24到1830年不等。九项研究包括成人，两个孩子以及一个成人和一个孩子。偏见的风险很高。偏见风险高的主要原因是分配顺序不足（混淆），并且研究没有盲目性。十一项研究评估了由教育和/或行为组成的AEI。所有这些研究都表明了有利于干预的效果方向。干预效果仅中等。在教育和行为干预研究中，大多数依从性措施显示出统计学上的显着差异。结合教育和行为干预成分的研究显示出更大的效果。所有具有统计学意义的研究均为多模式研究。包含个性化成分和更深入干预的研究显示出更大的效果。一项研究评估了提醒系统。没有报道效果大小。该研究显示无统计学显着性差异（p≥0.05）。教育性和行为性AEI可以提高依从性。特别是，多模式和个性化的干预措施似乎很有希望。但是，由于效果小，偏见的高风险以及依从性措施的无效性，对于未选定的患者群体（即也包括依从性患者），依从性干预措施的实际收益似乎有限。对于将针对意向性（行为）和无意依从性（提醒）的依从性增强组件进行组合的干预措施，尚无结论。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号