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      Patient Preference and Adherence (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on the growing importance of patient preference and adherence throughout the therapeutic process. Sign up for email alerts here.

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      Knowledge About Immunosuppressant Medication and Its Correlates in a German Kidney Transplant Population – Results of a KTx360° Substudy

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          Abstract

          Purpose

          After organ transplantation, adherence to immunosuppressive medication (ISM) is crucial to prevent organ rejection. To enable adherence, patients need to be well informed about the different aspects associated with their ISM. However, literature suggests that knowledge regarding ISM is often inadequate.

          Patients and Methods

          In a cross-sectional study, 702 patients after kidney transplantation participating in a structured multimodal follow-up program (KTx360°) were evaluated. We utilized a self-developed questionnaire which has been successfully used before to measure patients’ knowledge about the ISM. Above that we aimed to evaluate potential associations between sociodemographic, medical, donation-specific, and psychosocial variables including adherence, levels of depression and anxiety, perceived social support, and cognitive functioning with the knowledge level.

          Results

          The mean age of the patients was 52.4 years, 58.1% were men, and 66.6% were living in a partnership. The mean time since transplantation was 65.1 months. On average, patients answered 70.9% of the questions correctly. The percentage of correct answers per question differed considerably (54%–92%). In univariate analyses, knowledge levels were positively associated with female gender, current partnership, German as first language and better cognitive functioning. However, the effect sizes were small.

          Conclusion

          Taking into account that the patients after KTx can be expected to answer all questions correctly as they aim at basic knowledge, an average result of 70.9% corresponds to a moderate knowledge level. Consequently, the current educational approaches do not seem to be sufficient to inform all patients adequately. Further research is necessary on how to improve health knowledge in the long term.

          Most cited references27

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          Estimating GFR using the CKD Epidemiology Collaboration (CKD-EPI) creatinine equation: more accurate GFR estimates, lower CKD prevalence estimates, and better risk predictions.

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            The meaning and the measure of health literacy.

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              What is the meaning of health literacy? A systematic review and qualitative synthesis

              The objective of this review was to clarify what health literacy represents. A systematic review with qualitative syntheses was performed (CRD42017065149). Studies concerning health literacy in all settings were included. Studies before 15 March 2017 were identified from PubMed, Medline, Embase, Web of Science, Scopus, PsycARTICLES and the Cochrane Library. The included literature either had defined the concept of health literacy or made a detailed explanation of health literacy. A total of 34 original studies met the inclusion criteria, including 13 involved in previous systematic reviews and 21 new studies. Health literacy was commonly conceptualised as a set of knowledge, a set of skills or a hierarchy of functions (functional-interactive-critical). The construct of health literacy covers three broad elements: (1) knowledge of health, healthcare and health systems; (2) processing and using information in various formats in relation to health and healthcare; and (3) ability to maintain health through self-management and working in partnerships with health providers. Health literacy is defined as the ability of an individual to obtain and translate knowledge and information in order to maintain and improve health in a way that is appropriate to the individual and system contexts. This definition highlights the diversity of needs from different individuals and the importance of interactions between individual consumers, healthcare providers and healthcare systems.
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                Author and article information

                Journal
                Patient Prefer Adherence
                ppa
                ppa
                Patient preference and adherence
                Dove
                1177-889X
                25 September 2020
                2020
                : 14
                : 1699-1708
                Affiliations
                [1 ]Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School , Hannover, Germany
                [2 ]Project Kidney Transplantation 360° (NTx360°), Hannover Medical School , Hannover, Germany
                [3 ]Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School , Hannover, Germany
                [4 ]Department of Sports Medicine, Hannover Medical School , Hannover, Germany
                [5 ]Department of Nephrology and Hypertension, University Hospital Erlangen , Erlangen, Germany
                [6 ]Department of Nephrology and Hypertension, Hannover Medical School , Hannover, Germany
                Author notes
                Correspondence: Mariel NöhreDepartment of Psychosomatic Medicine and Psychotherapy, Hannover Medical School , Carl-Neuberg-Strasse 1, Hannover30625, GermanyTel +49 511 532 3932Fax +49 511 532 3190 Email noehre.mariel@mh-hannover.de
                Author information
                http://orcid.org/0000-0002-2166-3933
                http://orcid.org/0000-0002-7918-6957
                Article
                269201
                10.2147/PPA.S269201
                7524840
                847fd1ba-666d-47b5-9c5c-bfef7211275b
                © 2020 de Boer et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 24 June 2020
                : 06 August 2020
                Page count
                Figures: 0, Tables: 9, References: 38, Pages: 10
                Funding
                The study is supported by a grant the Federal Joint Committee of the Federal Republic of Germany under the number 01NVF16009.
                Categories
                Original Research

                Medicine
                health literacy,kidney transplantation,renal transplantation,adherence,immunosuppressive medication

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