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Medikamentenbezogene Non-Adherence und Symptombelastungen nach Herztransplantation

Medication-related non-adherence and symptom experiences in heart transplant patients

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Zeitschrift für Herz-,Thorax- und Gefäßchirurgie Aims and scope

Zusammenfassung

Medikamentenbezogene Non-Adherence stellt ein signifikantes Problem in der Langzeitnachsorge der Patienten nach solider Organtransplantation dar. Der Anteil der Patienten, die Schwierigkeiten bei der regelmäßigen, pünktlichen und korrekten Dosierung der Medikamente haben, muss mit etwa 20% kalkuliert werden. Non-Adherence resultiert in verkürzten Organ- und Überlebensraten sowie erhöhten Kosten für das Gesundheitssystem. Symptombelastungen stehen in direkter Beziehung zu (Non-)Adherence. Die Identifikation von Non-Adherence in neutraler, nicht bewertender Weise ist essenziell für die Initiierung effektiver Interventionen. Obwohl schon einige Adherence-verbessernde Strategien getestet wurden, ist die Evidenz unter Nutzung randomisierter Designs zwingend erweiterungsbedürftig. Nur kombinierte Strategien unter Nutzung edukativer, kognitiver, verhaltensorientierter und psychologisch-affektiver Interventionen sind im Langzeitverlauf zielführend.

Abstract

Medication-related non-adherence constitutes a significant problem in patients after solid organ transplantation in the long term. The prevalence of those experiencing difficulties with taking, timing and dosing is estimated to be 20% resulting in decreased organ and patient survival, and increased costs for the health care system. Symptom experiences are highly and directly related to (non)-adherence. Thus, the identification of non-adherence in a neutral, non-judgemental way becomes essential for the initiation of effective strategies for improving adherence. Although an array of interventions has been evaluated for their ability to improve adherence, the recent evidence using randomized, controlled trials remains weak. Combined interventions using educational, cognitive, behavioural and psychological affective strategies have been proven to be successful in the long term.

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Authors and Affiliations

  1. Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Medizinische Hochschule Hannover, Hannover, Deutschland

    C. Kugler

  2. Integriertes Forschungs- und Behandlungszentrum Transplantation, Hannover, Deutschland

    C. Kugler

  3. Fakultät für Gesundheit, Private Universität Witten/Herdecke, Stockumer Str. 12, 58453, Witten, Deutschland

    C. Kugler

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Kugler, C. Medikamentenbezogene Non-Adherence und Symptombelastungen nach Herztransplantation. Z Herz- Thorax- Gefäßchir 25 (Suppl 1), 20–25 (2011). https://doi.org/10.1007/s00398-011-0834-1

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  • DOI: https://doi.org/10.1007/s00398-011-0834-1

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