1
40
3
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1097/MOT.0b013e32833984a5" target="_blank" rel="noreferrer">http://doi.org/10.1097/MOT.0b013e32833984a5</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Adherence to medical recommendations and transition to adult services in pediatric transplant recipients
Publisher
An entity responsible for making the resource available
Current Opinion In Organ Transplantation
Date
A point or period of time associated with an event in the lifecycle of the resource
2010
Subject
The topic of the resource
Humans; Young Adult; Adult; Practice Guidelines as Topic; Drug Monitoring; Treatment Outcome; Risk Assessment; Risk Factors; Continuity of Patient Care; Health Behavior; Patient Education as Topic; Practice; adolescent; Attitudes; Adolescent Transitions; Health Knowledge; Graft Survival; Immunosuppressive Agents/therapeutic use; Graft Rejection/etiology/prevention & control; Medication Adherence; Organ Transplantation/adverse effects
Creator
An entity primarily responsible for making the resource
Shemesh E; Annunziato RA; Arnon R; Miloh T; Kerkar N
Description
An account of the resource
PURPOSE OF REVIEW: Nonadherence to treatment recommendations, especially when associated with transition to adult care providers, account, by some estimates, for most organ rejections and death in long-term pediatric survivors of solid organ transplantations. It is therefore imperative that providers become familiar with the issues related to those major risks and ways to address them. RECENT FINDINGS: It is possible, and important, to routinely measure adherence to medications by using one of several available and proven methods of surveillance. There are numerous ways to improve adherence, and it is in fact possible to improve adherence and therefore outcomes in the transplant setting. The transition to adult services is a vulnerable period. The authors believe that it is possible to improve the transition process, and suggestions are presented in this review. However, solid research into interventions to improve transition is lacking. SUMMARY: Nonadherence to medical recommendations is prevalent and leads to poor outcomes following otherwise successful pediatric transplantation. An especially vulnerable period is the time when a recipient transitions to adult care. Routine monitoring of adherence, evaluating and addressing barriers to adherence, and collaborative, multidisciplinary care are all expected to substantially improve adherence and reduce the risks associated with transition.
2010
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/MOT.0b013e32833984a5" target="_blank" rel="noreferrer">10.1097/MOT.0b013e32833984a5</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2010
Adolescent
Adolescent Transitions
Adult
Annunziato RA
Arnon R
Attitudes
Backlog
Continuity Of Patient Care
Current Opinion In Organ Transplantation
Drug Monitoring
Graft Rejection/etiology/prevention & control
Graft Survival
Health Behavior
Health Knowledge
Humans
Immunosuppressive Agents/therapeutic use
Journal Article
Kerkar N
Medication Adherence
Miloh T
Organ Transplantation/adverse effects
Patient Education as Topic
Practice
Practice Guidelines As Topic
Risk Assessment
Risk Factors
Shemesh E
Treatment Outcome
Young Adult
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1097/01.tp.0000110410.11524.7b" target="_blank" rel="noreferrer">http://doi.org/10.1097/01.tp.0000110410.11524.7b</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Noncompliance with immunosuppressive medications in pediatric and adolescent patients receiving solid-organ transplants
Publisher
An entity responsible for making the resource available
Transplantation
Date
A point or period of time associated with an event in the lifecycle of the resource
2004
Subject
The topic of the resource
Child; Humans; Treatment Refusal; adolescent; Adolescent Transitions; Graft Rejection/drug therapy; Immunosuppressive Agents/therapeutic use; Organ Transplantation
Creator
An entity primarily responsible for making the resource
Rianthavorn P; Ettenger RB; Malekzadeh M; Marik JL; Struber M
Description
An account of the resource
Advances in knowledge in transplantation have improved 1-year renal allograft survival in all age groups of pediatric patients. However, the results from many studies have shown that the long-term allograft survival is least successful in adolescent recipients. The major cause of late graft failure in adolescents can be contributed in large measure to medication noncompliance. Medication noncompliance in teenagers has been shown to be more than four times greater in adolescents than in adults. The teenage years are a time of transition from childhood to adulthood. Important tasks during this transition include the development of an autonomous identity that progresses to full independence. However, the cognitive skills and intellectual maturation of adolescents are still limited, and this is particularly true in adolescents with chronic diseases. They have difficulty with abstract thinking, particularly the conceptualization of future consequences of present actions. This leads to characteristic risk-taking behaviors, including noncompliance with medical treatments. This transition is more intricate for adolescents with chronic illness because of their physical limitations. There are a number of strategies that are helpful in mitigating noncompliance. Adolescents must be dealt with directly. Previous noncompliant behaviors need to be acknowledged and dealt with, because studies show that noncompliance is a "stable" personality attribute that persists over time. Efforts should be made to choose medications that have the least side effects. Psychological and psychiatric conditions such as posttraumatic stress disorder require early recognition, diagnosis, and treatment. It is necessary to build rapport with teenagers, and this should start before transplantation. A multidisciplinary approach with physicians, social workers, nurses, and transplant coordinators is an effective mean of enhancing compliance. These and other strategies outlined in this discussion will enable the adolescent to achieve good compliance rates and prevent graft loss.
2004
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/01.tp.0000110410.11524.7b" target="_blank" rel="noreferrer">10.1097/01.tp.0000110410.11524.7b</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2004
Adolescent
Adolescent Transitions
Backlog
Child
Ettenger RB
Graft Rejection/drug therapy
Humans
Immunosuppressive Agents/therapeutic use
Journal Article
Malekzadeh M
Marik JL
Organ Transplantation
Rianthavorn P
Struber M
Transplantation
Treatment Refusal
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1111/j.1399-3046.2004.00136.x" target="_blank" rel="noreferrer">http://doi.org/10.1111/j.1399-3046.2004.00136.x</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Non-compliance in children post-liver transplant. Who are the culprits?
Publisher
An entity responsible for making the resource available
Pediatric Transplantation
Date
A point or period of time associated with an event in the lifecycle of the resource
2004
Subject
The topic of the resource
Child; Female; Humans; Male; Survival Rate; Parents; Treatment Refusal; Socioeconomic Factors; Ambulatory Care; adolescent; Adolescent Transitions; Graft Rejection; Reoperation; Immunosuppressive Agents/therapeutic use; Liver Transplantation/mortality
Creator
An entity primarily responsible for making the resource
Falkenstein K; Flynn L; Kirkpatrick B; Casa-Melley A; Dunn S
Description
An account of the resource
Although non-compliance in pediatric liver transplants is known to be a major cause of late graft loss and patient mortality, follow-up seems inconsistent. As liver transplant becomes a luxury because of the shortage of organs, the need to maximize graft and patient survival by intense monitoring becomes a necessity. When evaluating children with elevated liver enzymes post-transplant, early or late non-compliance should always be suspected. The risk of non-compliance in children with chronic illness varies from 10 to 89%. In a study by Sudan et al. non-compliance was one of the leading causes of late mortality in children age 10-17 yr. Although it is well documented that teenagers have a high rate of non-compliance, the rate in the younger children has not been documented. In our series, we found that parental non-compliance comprises the majority of our problems with liver dysfunction, hospitalization, and graft loss. The purpose of this study was to evaluate the incidence of non-compliance in children post-liver transplant. A retrospective chart review of patient records from admissions and outpatient records was performed for documentation of elevated enzymes and low immunosuppressive levels. From July 1987 to December 2002, our program performed 266 liver transplants in 234 children, with 1-yr graft survival of 84% and 1-yr patient survival of 90%. Our overall patient survival was 85% with 77% graft survival. There were 40 children with documented non-compliance with mild to severe liver dysfunction in this study. Twenty-eight of these children were younger than 10 yr [28 of 40 (46%) <5 yr], and 12 (30%) were older than 10 yr at the time of rejection. In 10 of 40 children, there was one documented incident of non-compliance, while 26 of 40 had two to four incidents, and four had five or more documented events. Our children (50%) came from two-parent households. The remaining 50% were from single households. In 27 of 40 (68%) children, rejection was confirmed by liver biopsy. In children on cyclosporine (Neoral; Novartis, East Hanover, NJ, USA) with a known history of non-compliance and low immunosuppressive levels, C2 monitoring was performed to verify absorption. Admission for drug monitoring and verification of non-compliance was accomplished in 32 of 40 (80%). Four of the 40 children (10%) were retransplanted, and one child had died. In conclusion, non-adherence to medications remains a major source of graft loss and morbidity post-transplant. We found that non-compliance crosses all socio-economic and cultural groups and that flexibility of clinic hours, shortened time between visits, and decreased numbers and times of medication will increase adherence.
2004
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1111/j.1399-3046.2004.00136.x" target="_blank" rel="noreferrer">10.1111/j.1399-3046.2004.00136.x</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2004
Adolescent
Adolescent Transitions
Ambulatory Care
Backlog
Casa-Melley A
Child
Dunn S
Falkenstein K
Female
Flynn L
Graft Rejection
Humans
Immunosuppressive Agents/therapeutic use
Journal Article
Kirkpatrick B
Liver Transplantation/mortality
Male
Parents
Pediatric Transplantation
Reoperation
Socioeconomic Factors
Survival Rate
Treatment Refusal