Demographic Factors, Medication Adherence, and Post-transplant Health Outcomes : A Longitudinal Multilevel Modeling Approach
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature..
Few studies in pediatric solid organ transplantation have examined non-adherence to immunosuppressive medication over time and its associations with demographic factors and post-transplant outcomes including late acute rejection and hospitalizations. We examined longitudinal variation in patient Medication Level Variability Index (MLVI) adherence data from pediatric kidney, liver, and heart transplant recipients. Patient and administrative data from the United Network for Organ Sharing were linked with electronic health records and MLVI values for 332 patients. Multilevel mediation modeling indicated comparatively more variation in MLVI values between patients than within patients, longitudinally, over 10 years post transplant. MLVI values significantly predicted late acute rejection and hospitalization. MLVI partially mediated patient factors and post-transplant outcomes for patient age indicating adolescents may benefit most from intervention efforts. Results demonstrate the importance of longitudinal assessment of adherence and differences among patients. Efforts to promote medication adherence should be adapted to high-risk patients to increase likelihood of adherence.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
|---|---|
| Enthalten in: |
Journal of clinical psychology in medical settings - 31(2024), 1 vom: 16. März, Seite 163-173 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Killian, Michael O [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Immunosuppressive Agents |
|---|
| Anmerkungen: |
Date Completed 11.03.2024 Date Revised 11.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s10880-023-09970-4 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM360890474 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM360890474 | ||
| 003 | DE-627 | ||
| 005 | 20240311231854.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s10880-023-09970-4 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1323.xml |
| 035 | |a (DE-627)NLM360890474 | ||
| 035 | |a (NLM)37589865 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Killian, Michael O |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Demographic Factors, Medication Adherence, and Post-transplant Health Outcomes |b A Longitudinal Multilevel Modeling Approach |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 11.03.2024 | ||
| 500 | |a Date Revised 11.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. | ||
| 520 | |a Few studies in pediatric solid organ transplantation have examined non-adherence to immunosuppressive medication over time and its associations with demographic factors and post-transplant outcomes including late acute rejection and hospitalizations. We examined longitudinal variation in patient Medication Level Variability Index (MLVI) adherence data from pediatric kidney, liver, and heart transplant recipients. Patient and administrative data from the United Network for Organ Sharing were linked with electronic health records and MLVI values for 332 patients. Multilevel mediation modeling indicated comparatively more variation in MLVI values between patients than within patients, longitudinally, over 10 years post transplant. MLVI values significantly predicted late acute rejection and hospitalization. MLVI partially mediated patient factors and post-transplant outcomes for patient age indicating adolescents may benefit most from intervention efforts. Results demonstrate the importance of longitudinal assessment of adherence and differences among patients. Efforts to promote medication adherence should be adapted to high-risk patients to increase likelihood of adherence | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Longitudinal | |
| 650 | 4 | |a MLVI | |
| 650 | 4 | |a Medication adherence | |
| 650 | 4 | |a Pediatric organ transplantation | |
| 650 | 7 | |a Immunosuppressive Agents |2 NLM | |
| 700 | 1 | |a Little, Callie W |e verfasserin |4 aut | |
| 700 | 1 | |a Howry, Savarra K |e verfasserin |4 aut | |
| 700 | 1 | |a Watkivs, Madison |e verfasserin |4 aut | |
| 700 | 1 | |a Triplett, Kelli N |e verfasserin |4 aut | |
| 700 | 1 | |a Desai, Dev M |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of clinical psychology in medical settings |d 1994 |g 31(2024), 1 vom: 16. März, Seite 163-173 |w (DE-627)NLM093789920 |x 1573-3572 |7 nnns |
| 773 | 1 | 8 | |g volume:31 |g year:2024 |g number:1 |g day:16 |g month:03 |g pages:163-173 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s10880-023-09970-4 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 31 |j 2024 |e 1 |b 16 |c 03 |h 163-173 | ||