Date: Saturday, May 30, 2020
Session Name: Poster Session B: Psychosocial and Treatment Adherence
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) is a standardized, evaluation tool intended to assess psychosocial health in organ transplant candidates. The purpose of this study was to 1) compare SIPAT scores to standardized medication adherence assessment findings in kidney transplant (KTX) candidates undergoing living donor KTx and 2) assess data on these recipients reporting missing medications at 1 and 6 months post KTx.
*Methods: This was a retrospective study of HIV negative KTx candidates who underwent living donor KTx at our center 7/1/18-8/29/19. All candidates were seen by a transplant pharmacist for standardized medication adherence assessment, and education was provided based on findings. A transplant social worker saw all candidates for SIPAT scoring. Data on missing medications at 1 and 6 month post-KTx visits were collected from standardized documentation.
*Results: Seventy-seven KTx candidates were included. Medication adherence assessments were completed at a mean(SD) of 9 (±20) days pre-KTx. Data for missing/late medications was unavailable in 2 candidates. SIPAT scoring was completed at 264 (±139) days pre-KTX. Candidate mean (SD) age at adherence assessment was 46 (±10) yrs, 57% were male, 83% were white, 17% were re-KTx, and 97% completed ≥ high school education. Classification of SIPAT candidate scores were: “excellent” (43%), “good” (52%) and “minimally acceptable”(5%). Fewer “excellent candidates” demonstrated late/missed medications within 2 wks prior to their assessment, or medication discontinuation at any point without medical advice vs “good candidates” (Table 1). Overall, missed medications at 1 and 6 months post-KTx were <5%.
*Conclusions: 1) Only about two-thirds of KTx candidates classified by SIPAT as “excellent candidates” utilized adherence tools. 2) A lower percent of KTx candidates with “excellent” SIPAT scores acknowledged late/missed medications or stopping medications without medical advice versus those with “good ” SIPAT candidate scores. 3) Minimal medication non-adherence was documented at 1 and 6 months post KTx, suggesting that individualizing education based on adherence assessment findings in KTx candidates may potentially improve medication adherence.
|Parameter Evaluated||SIPAT “Excellent Candidate”(n = 33)||SIPAT “Good Candidate”(n = 44)||p value|
|Pill box use||17 (52%)||24 (55%)||0.82|
|Active medication list||22 (67%)||33 (75%)||0.50|
|Medication reminder(s) use||3 (9%)||8 (18%)||0.33|
|Medication(s) late in past 2 wks||4 (12%)||9 (21%)||0.38|
|Missed medication(s) in past 2 wks||6 (18%)||11 (25%)||0.58|
|Ever stopped medication(s) without medical advice||2 (6%)||9 (21%)||0.11|
To cite this abstract in AMA style:Trofe-Clark J, Malat G, Norris M, Bleicher M, Smith E, Sawinski D, Weinrieb R, Bloom R. Comparison of Stanford Integrated Psychosocial Assessment for Transplantation Scores to Medication Adherence Assessment Findings in Kidney Transplant Candidates Undergoing Living Donor Transplant [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/comparison-of-stanford-integrated-psychosocial-assessment-for-transplantation-scores-to-medication-adherence-assessment-findings-in-kidney-transplant-candidates-undergoing-living-donor-transplant/. Accessed October 24, 2020.
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