Measurement of the Immunosuppressant Possession Ratio by Transplant Clinical Pharmacists Captures a Non-Adherence Associated With Antibody-Mediated Rejection

Our objective was to calculate an immunosuppressant possession ratio (IPR) to diagnose non-adherence at the time of antibody-mediated rejection (ABMR). IPR was defined as the ratio of number of pills collected at the pharmacy to the number of pills prescribed over a defined period. In a first cohort...

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Vydané v:Transplant international Ročník 36; s. 11962
Hlavní autori: Chambord, Jérémy, Chauveau, Bertrand, Djabarouti, Sarah, Vignaud, Jean, Taton, Benjamin, Moreau, Karine, Visentin, Jonathan, Merville, Pierre, Xuereb, Fabien, Couzi, Lionel
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Switzerland Frontiers Media SA 2023
Frontiers Media
Frontiers Media S.A
Predmet:
adherence
Antibodies
antibody-mediated rejection
Biopsy
Case-Control Studies
clinical pharmacist
Coefficient of variation
Drug stores
Electronic monitoring
Graft rejection
Graft Rejection - diagnosis
Graft Rejection - prevention & control
Health Archive
Human health and pathology
Humans
Immunology
immunosuppresant possession ratio
Immunosuppressive agents
Immunosuppressive Agents - therapeutic use
Immunotherapy
Isoantibodies
Kidney Transplantation
Kidney transplants
Life Sciences
Medical records
Patients
Pharmacists
Rejection
Santé publique et épidémiologie
Software
Tacrolimus
Urology and Nephrology
immunosuppresant possession ratio
adherence
clinical pharmacist
kidney transplantation
antibody-mediated rejection
antibodymediated rejection
ISSN:1432-2277, 0934-0874, 1432-2277
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Shrnutí:Our objective was to calculate an immunosuppressant possession ratio (IPR) to diagnose non-adherence at the time of antibody-mediated rejection (ABMR). IPR was defined as the ratio of number of pills collected at the pharmacy to the number of pills prescribed over a defined period. In a first cohort of 91 kidney transplant recipients (KTRs), those with an IPR < 90% had more frequently a tacrolimus through level coefficient of variation >30% than patients with an IPR = 100% (66.7% vs. 29.4%, p = 0.05). In a case-control study, 26 KTRs with ABMR had lower 6 months IPRs than 26 controls (76% vs. 99%, p < 0.001). In KTRs with ABMR, non-adherence was more often diagnosed by a 6 months IPR < 90% than by clinical suspicion (73.1% vs 30.8%, p = 0.02). In the multivariable analysis, only de novo DSA and 6 months IPR < 90% were independently associated with ABMR, whereas clinical suspicion was not (odds ratio, 4.73; 95% CI, 1.17–21.88; p = 0.03; and odds ratio, 6.34; 95% CI, 1.73–25.59; p = 0.007, respectively). In summary, IPR < 90% is a quantifiable tool to measure immunosuppressant non-adherence. It is better associated with ABMR than clinical suspicion of non-adherence.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1432-2277
0934-0874
1432-2277
DOI:10.3389/ti.2023.11962