J Korean Biol Nurs Sci.  2016 Feb;18(1):17-26. 10.7586/jkbns.2016.18.1.17.

Current Interventions to Improve Adherence to Immunosuppressants in Liver Transplant Recipients: a Systematic Review

• Kim SH
• Lee YJ
• Lee SY
• Chu SH

• KMID: 2173176
• DOI: http://doi.org/10.7586/jkbns.2016.18.1.17

Abstract

PURPOSE
Adherence to immunosuppressants is the key to prevent organ rejection in organ transplant recipients. The purpose of this study was to investigate current interventions to improve adherence to immunosuppressants in liver transplant recipients.
METHODS
A systemic literature search was done using PubMed, Embase, Cochrane Library, CINAHL and four Korean databases to identify experimental studies reported in English or Korean up to and including 2015. We identified eight intervention studies on the adherence to immunosuppressants in liver transplant recipients independently reviewed by two reviewers. The quality and risk of bias of the selected studies were assessed.
RESULTS
Education, conversion of regimen, and text messaging were identified as intervention techniques to improve adherence. We found positive results in three out of four studies implementing educational strategies, but the results were not sufficient to draw a definite conclusion. Conversion from a twice-daily tacrolimus-based regimen to a once-daily tacrolimus extended-release formula was used in three adult-only studies and its effectiveness was confirmed. One study showed that improved adherence and outcomes were effected by using text messaging with pediatric patients.
CONCLUSION
Future research is needed to facilitate interventions to improve adherence to immunosuppressants in various ages of patients including pediatric/adolescent liver transplant recipients.

Keyword

Liver transplant recipients; Immunosuppressant; Adherence; Systematic review

MeSH Terms

Bias (Epidemiology)
Education
Humans
Immunosuppressive Agents*
Clinical Trial
Liver*
Tacrolimus
Text Messaging
Transplantation*
Transplants
Immunosuppressive Agents
Tacrolimus