Extended Adherence from HTX-Patients: A Closer Look

Abstract

Introduction: Compliance (adherence) is a multifactor influenced concept. Lack of adherence can cause severe health problems in longtime Tx- Patients. Beside a reliable and correct medicament-intake patients are expected not to smoke, as well as to reduce their infection risk via contact to animals and germ-rich food. The prevalence varies considerably. Methods: In this cross-sectional study 858 Patients who underwent heart-transplantation were corresponded and asked to participate anonymous. 524 patients (61 %) replied to the questionnaires about medical-adherence (ITAS, ITBS, COMPAD), anxiousness and depressivity (HADS-D) and questions about nutrition and animal husbandry. Because the willingness to respond varied substantial between the forms, we used exclusion missing data pairwise. Descriptive Statistics and Chi-square tests were used to compute the results. Results: From 467 patients (54.4 %) over 18 years and completed ITAS, data could be computed.369 (79.2 %) male, and 97 (20.8 %) female participants could be included, one missing data. The men were on average 61.2 years old, women were significant younger (M = 53.5 years, p < .01). Age of the whole sample ranged from 18 to 90 years.456 participants (95.7 %) answered the question how many pills per day they have to take (Median = 14, range 1 - 77). Measured with ITAS 72.2 % of all participants showed very reliable, 14.4 % a reduced and 13.4 % an alarming unreliable immunosuppressant medicine intake.97 (20.3 %) patients had a job, most of them (62.9 %, N = 61) fulltime. Compared to not-working people patients with work were significant less compliant to medicine taking measured with ITAS (p = .004)Measured with HADS (cutoffs > 8, > 11), 46 patients (9.9 %) showed a slightly, 10.9 % (N = 51) a notable elevated score for depressivity and 14.1 % (N = 66) respective 12.4 % (N = 58) for anxiousness.71 persons (13.3 %) affirmed that they own at least one animal (multiple choice) with a lion's share for dogs (9 %, N = 41) and cats (4.4%, N = 21). To eat germ-rich food like raw meat or mould cheese daily or several a week indicated 9.2 % (raw meat, N = 44), and 8.4 % (mould cheese, N = 40) of the patients and up to 30 % stated for ‘occasionally’. 15 % of the patients (N = 71) indicated that they believed germ-rich food would not harm them. Conclusion: Although the adherence was ascertained only by self-assessment and a positive selection by the response rate has to be assumed, a medicine-referred non adherence of 27.8 % could be demonstrated. A worrisome infection risk related to germ-rich food and domestic animal keeping was confirmed. Interventions to increase post HTX adherence should refer to that purposefully.