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J Card Fail ; 25(12): 948-958, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31276804

RESUMO

BACKGROUND: Young-adult heart transplant recipients transferring to adult care are at risk for poor health outcomes. We conducted a pilot randomized controlled trial to determine the feasibility of and to test a transition intervention for young adults who underwent heart transplantation as children and then transferred to adult care. METHODS: Participants were randomized to the transition intervention (4 months long, focused on heart-transplant knowledge, self-care, self-advocacy, and social support) or usual care. Self-report questionnaires and medical records data were collected at baseline and 3 and 6 months after the initial adult clinic visit. Longitudinal analyses comparing outcomes over time were performed using generalized estimating equations and linear mixed models. RESULTS: Transfer to adult care was successful and feasible (ie, excellent participation rates). The average patient standard deviation of mean tacrolimus levels was similar over time in both study arms and < 2.5, indicating adequate adherence. There were no between-group or within-group differences in percentage of tacrolimus bioassays within target range (> 50%). Average overall adherence to treatment was similarly good in both groups. Rates of appointment keeping through 6 months after transfer declined over time in both groups. CONCLUSIONS: The feasibility of the study was demonstrated. Our transition intervention did not improve outcomes.


Assuntos
Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/terapia , Transplante de Coração/métodos , Transferência de Pacientes/métodos , Autocuidado/métodos , Adolescente , Estudos de Viabilidade , Feminino , Insuficiência Cardíaca/psicologia , Transplante de Coração/psicologia , Humanos , Imunossupressores/uso terapêutico , Masculino , Projetos Piloto , Estudos Prospectivos , Autocuidado/psicologia , Adulto Jovem
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