Growing pains: Non-adherence with the immunosuppressive regimen in adolescent transplant recipients
Fabienne Dobbels,
Rita Van Damme-Lombaert,
Johan Vanhaecke,
Sabina De Geest,
Fabienne Dobbels
Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium
Heart Transplant Program, University Hospitals of Leuven, School of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
Search for more papers by this authorRita Van Damme-Lombaert
Pediatric Transplant Program, University Hospitals of Leuven, School of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
Search for more papers by this authorJohan Vanhaecke
Heart Transplant Program, University Hospitals of Leuven, School of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
Search for more papers by this authorSabina De Geest
Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium
Institute of Nursing Science, University of Basel, Basel, Switzerland From the Pediatric Symposium at the ATC, Boston, MA – May 15, 2004.
Search for more papers by this authorFabienne Dobbels,
Rita Van Damme-Lombaert,
Johan Vanhaecke,
Sabina De Geest,
Fabienne Dobbels
Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium
Heart Transplant Program, University Hospitals of Leuven, School of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
Search for more papers by this authorRita Van Damme-Lombaert
Pediatric Transplant Program, University Hospitals of Leuven, School of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
Search for more papers by this authorJohan Vanhaecke
Heart Transplant Program, University Hospitals of Leuven, School of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
Search for more papers by this authorSabina De Geest
Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium
Institute of Nursing Science, University of Basel, Basel, Switzerland From the Pediatric Symposium at the ATC, Boston, MA – May 15, 2004.
Search for more papers by this authorFabienne Dobbels MSc, Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Kapucijnenvoer 35/4, B-3000 Leuven, Belgium
Tel.: +32 16 33 6976
Fax: +32 16 33 6970
E-mail: [email protected]
Abstract
Abstract: One-year graft and patient survival are better in adolescent transplant recipients (age 11–19 years) than in younger (age < 11 years) pediatric transplant recipients. However, several groups found that long-term outcomes (> i.e. 5 year post-transplant) in the adolescent age group are significantly worse than in younger transplant recipients.
A behavioral factor that could explain an important part of the poorer clinical outcome in adolescent transplant recipients is non-compliance with medication taking. Adolescents, like all organ transplant recipients irrespective of their age, must adhere to a life-long immunosuppressive regimen in addition to other aspects of their therapeutic regimen. Therefore, adolescent transplant recipients, as all transplant patients, should be regarded as a chronically ill patient population in whom behavioral and psychosocial management is equally important as state-of-the-art medical management.
This paper provides an overview of the current knowledge on prevalence, clinical consequences, and risk-factors for non-compliance with the immunosuppressive regimen in adolescent transplant recipients and offers some suggestions for adolescent-tailored interventions to improve medication adherence.
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