Poster 02. Anti-hypertensive drug adherence in lung transplant recipients

Thursday 14 march 2019

12:33 - 12:36h

Categories: Nursing, Postersessie

Parallel session: Postersessies 1 - Nursing

I. van Ewijk, E.A. van de Graaf. 

Dept. of Pulmonary Transplantation, University Medical Center Utrecht, Utrecht,The Netherlands. 

Background: Lung transplant recipients are on life-long use of immunosuppressants. These immunosuppressive drugs cause side effects, and will increase the chance to develop hypertension and renal impairment. Despite the importance of adherence for taking antihypertensive drugs, no studies have been performed in patients after lung transplantation. The nurse practitioner can play an important role in diagnosing, treating and informing lung transplant recipients about antihypertensive medication when necessary during follow up.

To evaluate the role of the Nurse Practitioner (NP) and to stimulate drug adherence and provide good information to patients it was necessary to identify factors which are involved in adherence. This study was initiated to evaluate the extent of anti-hypertensive drug adherence in lung transplant recipients with hypertension and/or renal impairment. It was also meant to gain more insight in what motives could contribute to adherence. The next goal was to contribute to better information and support to lung transplant patients by an NP.

Methods: A total of 21 lung transplant recipients with Cystic Fibrosis (CF) filled in a questionnaire in which the adherence to antihypertensive agents was measured. In addition, the attitude towards drug use was measured. The questionnaire contained the MMAS-questionnaire and nine different theses. Thereafter, eight of the 21 patients were interviewed by semi-structured interviews. Different motives to adherence were assessed in those interviews. A list of topics was used.

Results: Incidence rates of high adherence was 76.2% and 23.8% scored a medium adherence. Overall, the attitude towards drug use was positive. Most of the lung transplant recipients (88.9%) agreed with the treatment with medication and no one experienced difficulty in taking medication.

The patients found it hard to differentiate between the side effects of antihypertensive drugs and the side effects of other medication. More than half (55.6%) who completed the questionnaire indicated that the information at the start with antihypertensive drugs was insufficient.

Conclusions: A high degree of adherence was scored. Motives that could reduce adherence were absence of complaints due to hypertension and/or renal impairment, side effects of antihypertensive agents, high number of medication, reduced importance of antihypertensive agents compared to immunosuppressants, absence of daily routine and limited information. The patients had limited knowledge about the role of a NP.