Prevalence and correlates of non-adherence to immunosuppressants and to health behaviours in patients after kidney transplantation in Brazil - the ADHERE BRAZIL multicentre study: a cross-sectional study protocol

dc.citation.volume19
dc.contributor.authorSanders-Pinheiro, Helady
dc.contributor.authorBasile Colugnati, Fernando Antonio
dc.contributor.authorMarsicano, Elisa Oliveira
dc.contributor.authorDe Geest, Sabina
dc.contributor.authorPestana Medina, Jose Osmar [UNIFESP]
dc.coverageLondon
dc.date.accessioned2020-07-08T13:09:40Z
dc.date.available2020-07-08T13:09:40Z
dc.date.issued2018
dc.description.abstractBackground: Non-adherence to immunosuppressive therapy is a prevalent risk factor for poor clinical and after kidney transplantation (KT), and has contributed to the lack of improvement in long-term graft survival over the past decade. Understanding the multilevel correlates and risk factors of non-adherence is crucial to determine the optimal level for planning interventions, namely at the patient, health care provider, KT centre, and health care system level. Brazil, having the largest public transplantation program in the world and with regional differences regarding access to health services and service implementation, is in a unique position to study this multilevel approach. Therefore, the Adhere Brazil Study (ADHERE BRAZIL) was designed to assess the prevalence and variability of non-adherence to immunosuppressants and to health behaviours among adult KT recipients in Brazil, and to assess the multilevel correlates of non-adherence to immunosuppressive medication. We describe the rationale, design, and methodology of the ADHERE BRAZIL study. Methods/Design: This is an observational, cross-sectional, multicentre study that includes 20 Brazilian KT centres. A stratified sampling approach is used, based on strata, with the following characteristics considered: geographical region and transplant activity (number of KTs per year). A random sample of patients (proportional to the size of the centre within each stratum) is selected from each centre. The prevalence of different health behaviours is assessed through self-report. The assessment of multilevel correlates of non-adherence is guided by the ecological model that considers factors at the level of the patient, health-care professional, and transplant centre, using established instruments or instruments developed for this study. Data will be collected over an 18-month period, with information obtained during the regular follow-up visits to the transplant outpatient clinic and directly entered into the Research Electronic Data Capture (RedCap) system. Data entry is performed by a trained professional who is part of the transplant team. The data collection began in December 2015. Discussion: This multicentre study is the first to evaluate multilevel correlates of non-adherence in KT patients and will provide a reliable estimate of non-adherence in Brazilian KT patients.en
dc.description.affiliationUniv Fed Juiz de Fora, Renal Transplantat Unit, Univ Hosp, Rua Benjamin Constant 1044-1001, BR-36015400 Juiz De Fora, MG, Brazil
dc.description.affiliationNIEPEN, Rua Benjamin Constant 1044-1001, BR-36015400 Juiz De Fora, MG, Brazil
dc.description.affiliationUniv Basel, Inst Nursing Sci, Dept Publ Hlth, Fac Med, Basel, Switzerland
dc.description.affiliationKatholieke Univ Leuven, Acad Ctr Nursing & Midwifery, Dept Publ Hlth & Primary Care, Fac Med, Leuven, Belgium
dc.description.affiliationUniv Fed Sao Paulo, Hosp Rim & Hipertensao, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Hosp Rim & Hipertensao, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipCoordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)
dc.description.sponsorshipFundacao Instituto Mineiro de Estudos e Pesquisas em Nefrologia (IMEPEN)
dc.description.sponsorshipLibbs Pharmaceutical Ltd.
dc.description.sponsorshipAstellas Pharma Brazil Ltd.
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.1186/s12882-018-0840-6
dc.identifier.citationBmc Nephrology. London, v. 19, p. -, 2018.
dc.identifier.doi10.1186/s12882-018-0840-6
dc.identifier.fileWOS000426085000001.pdf
dc.identifier.issn1471-2369
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/54122
dc.identifier.wosWOS:000426085000001
dc.language.isoeng
dc.publisherBiomed Central Ltd
dc.relation.ispartofBmc Nephrology
dc.rightsAcesso aberto
dc.subjectPatient adherenceen
dc.subjectMedication nonadherenceen
dc.subjectImmunosuppressionen
dc.subjectHealth behaviouren
dc.subjectKidney transplantationen
dc.subjectBrazilen
dc.subjectDesignen
dc.subjectHealthcare systemen
dc.titlePrevalence and correlates of non-adherence to immunosuppressants and to health behaviours in patients after kidney transplantation in Brazil - the ADHERE BRAZIL multicentre study: a cross-sectional study protocolen
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