Gender Differences in Adherence to Nonpharmacologic Recommendations after Heart Transplant: A Secondary Analysis from the International BRIGHT Study

Abstract

The aim of this study was to describe and compare gender differences in adherence and nonadherence to nonpharmacologic recommendations after heart transplant (HTx) globally; in Europe, North America, South America and Australia. This a sub-analysis of self-reported data of 1397 adult HTx recipients from the 36- HTx-center, 11-country, 4-continent, cross- sectional BRIGHT study (ClinicalTrials. gov ID: NCT01608477). The analysis included descriptive statistics. Two-sample t-tests were used to compare the mean gender differences in health behaviors post-HTx, such as sun protection, diet keeping, physical activity, and appointment keeping; and chi-square tests were used to evaluate the relationship between female and male adherence and nonadherence to alcohol use and to smoking. Females were more adherent to sun protection in Australia (p=0.03), and in the total of all continents, compared to males (p=0.00). Females were more adherent to 30-minute moderate physical activity 5 days-a-week, in each continent, and in the total of all continents (p-values=0.00, 0.02, 0.04, 0.03, and 0.00 respectively). Complying with 20-minutes of vigorous physical activity 3 days-a-week, females were more adherent in every continent, except for Australia, and in the total of all continents (p-values=0.00, 0.00, 0.00, and 0.00 respectively). Finally, females were more adherent than males in abstaining from smoking in Europe, and in the total of all continents (p=0.01, 009 respectively). The findings support the hypothesis that females are, in general, more adherent than males to post-HTx recommendations. This study bridges a gap in the literature, by providing evidence about female and male health behaviors after HTx. This gender-specific information should be used in designing behavioral health gender-specific interventions to improve adherence in transplantation.