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Medication Nonadherence After Lung Transplantation in Adult Recipients.

Publication ,  Journal Article
Castleberry, AW; Bishawi, M; Worni, M; Erhunmwunsee, L; Speicher, PJ; Osho, AA; Snyder, LD; Hartwig, MG
Published in: Ann Thorac Surg
January 2017

BACKGROUND: Our objective was to identify potential avenues for resource allocation and patient advocacy to improve outcomes by evaluating the association between recipient sociodemographic and patient characteristics and medication nonadherence after lung transplantation. METHODS: States US adult, lung-only transplantations per the United Network for Organ Sharing database were analyzed from October 1996 through December 2006, based on the period during which nonadherence information was recorded. Generalized linear models were used to determine the association of demographic, disease, and transplantation center characteristics with early nonadherence (defined as within the first year after transplantation) as well as late nonadherence (years 2 to 4 after transplantation). Outcomes comparing adherent and nonadherent patients were also evaluated. RESULTS: Patients (n = 7,284) were included for analysis. Early and late nonadherence rates were 3.1% and 10.6%, respectively. Factors associated with early nonadherence were Medicaid insurance compared with private insurance (adjusted odds ratio [AOR] 2.45, 95% confidence interval [CI]: 1.16 to 5.15), and black race (AOR 2.38, 95% CI: 1.08 to 5.25). Medicaid insurance and black race were also associated with late nonadherence (AOR 2.38, 95% CI: 1.51 to 3.73 and OR 1.73, 95% CI: 1.04 to 2.89, respectively), as were age 18 to 20 years (AOR 3.41, 95% CI: 1.29 to 8.99) and grade school or lower education (AOR 1.88, 95% CI: 1.05 to 3.35). Early and late nonadherence were both associated with significantly shorter unadjusted survival (p < 0.001). CONCLUSIONS: Identifying patients at risk of nonadherence may enable resource allocation and patient advocacy to improve outcomes.

Duke Scholars

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Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

January 2017

Volume

103

Issue

1

Start / End Page

274 / 280

Location

Netherlands

Related Subject Headings

  • Young Adult
  • United States
  • Transplant Recipients
  • Time Factors
  • Retrospective Studies
  • Respiratory System
  • Prognosis
  • Middle Aged
  • Medication Adherence
  • Medicare
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Castleberry, A. W., Bishawi, M., Worni, M., Erhunmwunsee, L., Speicher, P. J., Osho, A. A., … Hartwig, M. G. (2017). Medication Nonadherence After Lung Transplantation in Adult Recipients. Ann Thorac Surg, 103(1), 274–280. https://doi.org/10.1016/j.athoracsur.2016.06.067
Castleberry, Anthony W., Muath Bishawi, Mathias Worni, Loretta Erhunmwunsee, Paul J. Speicher, Asishana A. Osho, Laurie D. Snyder, and Matthew G. Hartwig. “Medication Nonadherence After Lung Transplantation in Adult Recipients.Ann Thorac Surg 103, no. 1 (January 2017): 274–80. https://doi.org/10.1016/j.athoracsur.2016.06.067.
Castleberry AW, Bishawi M, Worni M, Erhunmwunsee L, Speicher PJ, Osho AA, et al. Medication Nonadherence After Lung Transplantation in Adult Recipients. Ann Thorac Surg. 2017 Jan;103(1):274–80.
Castleberry, Anthony W., et al. “Medication Nonadherence After Lung Transplantation in Adult Recipients.Ann Thorac Surg, vol. 103, no. 1, Jan. 2017, pp. 274–80. Pubmed, doi:10.1016/j.athoracsur.2016.06.067.
Castleberry AW, Bishawi M, Worni M, Erhunmwunsee L, Speicher PJ, Osho AA, Snyder LD, Hartwig MG. Medication Nonadherence After Lung Transplantation in Adult Recipients. Ann Thorac Surg. 2017 Jan;103(1):274–280.

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

January 2017

Volume

103

Issue

1

Start / End Page

274 / 280

Location

Netherlands

Related Subject Headings

  • Young Adult
  • United States
  • Transplant Recipients
  • Time Factors
  • Retrospective Studies
  • Respiratory System
  • Prognosis
  • Middle Aged
  • Medication Adherence
  • Medicare