Blood Levels Are Only Reliable Drug Compliance Measure in Pediatric Transplant Patients

[Guest guest]

Blood Levels Are Only Reliable Drug Compliance Measure in Pediatric

Transplant Patients

NEW YORK (Reuters Health) Apr 09 - An analysis of immunosuppression

adherence among pediatric and adolescent liver transplant recipients shows

that the only dependable measures of compliance are blood drug levels, and

not the reports of patients, parents, or clinicians.

At the Mount Sinai Medical Center in New York, Dr. Eyal Shemesh and

colleagues analyzed data collected in their pediatric liver transplant

program's adherence assessment protocol. Adherence was assessed on the basis

of questionnaires completed by nurses, physicians, caregivers, and patients.

In addition, a standard deviation was calculated for blood levels of

tacrolimus over time for each patient. If the standard deviation was high,

the patient was assumed to be taking the medication erratically.

Medical outcome measures included rejection episodes, number of biopsies

regardless of the results, hospital admissions, and hospital

length-of-stays.

Among 81 patients whose transplants had been performed at least 12 months

previously, " the only method that predicted the medical outcome variables

(biopsy-proven rejection and number of biopsies) was the standard deviation

of medication blood levels, " the authors write. None of the questionnaire

responses were predictive. Furthermore, the clinicians' assessments did not

correlate with those of patients or caregivers.

The results are published in the April 2004 issue of Pediatrics.

" The transition of responsibility for medication taking occurred

approximately at the age of 12 years, " the researchers note. " Forgetfulness

was cited as the most common reason for nonadherence by patients and

caregivers. "

They conclude that " interventions targeting adherence should address the

child's increasing role beginning in early adolescence. "

Pediatrics 2004;113:825-832.

[Guest guest]

Blood Levels Are Only Reliable Drug Compliance Measure in Pediatric

Transplant Patients

NEW YORK (Reuters Health) Apr 09 - An analysis of immunosuppression

adherence among pediatric and adolescent liver transplant recipients shows

that the only dependable measures of compliance are blood drug levels, and

not the reports of patients, parents, or clinicians.

At the Mount Sinai Medical Center in New York, Dr. Eyal Shemesh and

colleagues analyzed data collected in their pediatric liver transplant

program's adherence assessment protocol. Adherence was assessed on the basis

of questionnaires completed by nurses, physicians, caregivers, and patients.

In addition, a standard deviation was calculated for blood levels of

tacrolimus over time for each patient. If the standard deviation was high,

the patient was assumed to be taking the medication erratically.

Medical outcome measures included rejection episodes, number of biopsies

regardless of the results, hospital admissions, and hospital

length-of-stays.

Among 81 patients whose transplants had been performed at least 12 months

previously, " the only method that predicted the medical outcome variables

(biopsy-proven rejection and number of biopsies) was the standard deviation

of medication blood levels, " the authors write. None of the questionnaire

responses were predictive. Furthermore, the clinicians' assessments did not

correlate with those of patients or caregivers.

The results are published in the April 2004 issue of Pediatrics.

" The transition of responsibility for medication taking occurred

approximately at the age of 12 years, " the researchers note. " Forgetfulness

was cited as the most common reason for nonadherence by patients and

caregivers. "

They conclude that " interventions targeting adherence should address the

child's increasing role beginning in early adolescence. "

Pediatrics 2004;113:825-832.

[Guest guest]

Blood Levels Are Only Reliable Drug Compliance Measure in Pediatric

Transplant Patients

NEW YORK (Reuters Health) Apr 09 - An analysis of immunosuppression

adherence among pediatric and adolescent liver transplant recipients shows

that the only dependable measures of compliance are blood drug levels, and

not the reports of patients, parents, or clinicians.

At the Mount Sinai Medical Center in New York, Dr. Eyal Shemesh and

colleagues analyzed data collected in their pediatric liver transplant

program's adherence assessment protocol. Adherence was assessed on the basis

of questionnaires completed by nurses, physicians, caregivers, and patients.

In addition, a standard deviation was calculated for blood levels of

tacrolimus over time for each patient. If the standard deviation was high,

the patient was assumed to be taking the medication erratically.

Medical outcome measures included rejection episodes, number of biopsies

regardless of the results, hospital admissions, and hospital

length-of-stays.

Among 81 patients whose transplants had been performed at least 12 months

previously, " the only method that predicted the medical outcome variables

(biopsy-proven rejection and number of biopsies) was the standard deviation

of medication blood levels, " the authors write. None of the questionnaire

responses were predictive. Furthermore, the clinicians' assessments did not

correlate with those of patients or caregivers.

The results are published in the April 2004 issue of Pediatrics.

" The transition of responsibility for medication taking occurred

approximately at the age of 12 years, " the researchers note. " Forgetfulness

was cited as the most common reason for nonadherence by patients and

caregivers. "

They conclude that " interventions targeting adherence should address the

child's increasing role beginning in early adolescence. "

Pediatrics 2004;113:825-832.

[Guest guest]

Blood Levels Are Only Reliable Drug Compliance Measure in Pediatric

Transplant Patients

NEW YORK (Reuters Health) Apr 09 - An analysis of immunosuppression

adherence among pediatric and adolescent liver transplant recipients shows

that the only dependable measures of compliance are blood drug levels, and

not the reports of patients, parents, or clinicians.

At the Mount Sinai Medical Center in New York, Dr. Eyal Shemesh and

colleagues analyzed data collected in their pediatric liver transplant

program's adherence assessment protocol. Adherence was assessed on the basis

of questionnaires completed by nurses, physicians, caregivers, and patients.

In addition, a standard deviation was calculated for blood levels of

tacrolimus over time for each patient. If the standard deviation was high,

the patient was assumed to be taking the medication erratically.

Medical outcome measures included rejection episodes, number of biopsies

regardless of the results, hospital admissions, and hospital

length-of-stays.

Among 81 patients whose transplants had been performed at least 12 months

previously, " the only method that predicted the medical outcome variables

(biopsy-proven rejection and number of biopsies) was the standard deviation

of medication blood levels, " the authors write. None of the questionnaire

responses were predictive. Furthermore, the clinicians' assessments did not

correlate with those of patients or caregivers.

The results are published in the April 2004 issue of Pediatrics.

" The transition of responsibility for medication taking occurred

approximately at the age of 12 years, " the researchers note. " Forgetfulness

was cited as the most common reason for nonadherence by patients and

caregivers. "

They conclude that " interventions targeting adherence should address the

child's increasing role beginning in early adolescence. "

Pediatrics 2004;113:825-832.