How to improve adherence to treatment among heart transplant recipients? Literature review and own experience

Background : Organ transplantation is a treatment of choice for selected patients with end stage organ diseases. Medication adherence (MA) is essential for the survival of organs grafts, however complexity of the medication – taking regimen makes adherence difficult and is the reason of graft loss and graft rejection.

Aim of the study : To assess adherence in patients after heart transplantation (HTX). Evaluation of nursing interventions which improve adherence based on literature and own experience

Material and methods : The group of 66 patients after HTX were administered a questionnaire that included the validated 6-item Morisky Medication Adherence Scale.

Results : The age of participants was ranged 23-73 years, 1-17 years after HTX. 35% of recipients admitted to having missed a dose of immunosuppressive medications, 41% vs. other drugs. 3-6% cut back or stopped taking their medication because they felt worse or they felt their conditions were under control vs. 21.21-30.3%. Literature review and Evidence Based Nursing indicates the need to combine various methods to increase MA.

Nursing interventions:

• evaluation of the reasons for not following the recommendations,

• choosing the form and methods to educate patients,

• promoting self-care.

Evaluation: there were no episodes of acute rejection, low levels of drugs resulting from nonadhrence.

Conclusions : Nursing actions should focus on combining the methods of patient education and assessing the reasons for not following the recommendations of the therapeutic team. A combination of interventions in nursing allows building a good adherence in patients after HTX.