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Master Thesis

Prédire l'adhésion aux traitements immunosuppresseurs chez le patient transplanté‎ : étude PrATIS

Abstract : Non-adherence to immunosuppressive (IS) therapy is frequently associated with poor outcomes. Identifying factors predicting adherence may be useful to screen patients who need educative interventions. The primary objective of this study was to test whether a psycho-social-cognitive model: the Theory of Planned Behavior, beliefs and satisfaction with medication predict adherence in transplant patients. We also assessed the influence of sociodemographic and therapeutic parameters. Data were collected during 6 months. Adherence was assessed with a self-reported medication adherence scale (derived from the Morisky-Green questionnaire) and IS blood trough concentrations. TPB was assessed with a specific questionnaire, Satisfaction and beliefs with the SatMed-Q® and the BMQ®, respectively. We enrolled 157 patients including lung (n=36), heart (n=44), liver (n=42) and kidney (n=44). TPB variables (subjective norms β=0.22 p<0.01; perceived behavioral control β=0.53 p<0.01; but not attitudes) explained 41% of the variance in intentions to adhere to IS. Satisfaction was significantly correlated to adherence (r=0.3 p<0.01) as well as health beliefs with general and specific score (r= 0.2 p<0.01, r= 0.3 p<0.01). Factors independently associated with an increased risk of non-adherence were living alone (OR=2.8 p=0.03), heart transplantation (OR=3.5 p=0.01), everolimus (OR=5.0 p=0.03) and negatives beliefs towards drugs (OR=1.1 p=0.01). Understanding the determinants of non-adherence provides pathways to screen patient at risk for non-adherence or to identify patients early who could benefit from adherence interventions. In a second time interventions could be targeted to those factors.
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Master Thesis
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Submitted on : Wednesday, April 4, 2012 - 3:52:25 PM
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  • HAL Id : dumas-00685250, version 1

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Amélie Hugon. Prédire l'adhésion aux traitements immunosuppresseurs chez le patient transplanté‎ : étude PrATIS. Sciences pharmaceutiques. 2011. ⟨dumas-00685250⟩

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