期刊
JOURNAL OF CARDIAC FAILURE
卷 25, 期 12, 页码 948-958出版社
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.cardfail.2019.06.011
关键词
Heart transplantation; Transition program
资金
- National Institutes of Health (NIH), National Heart, Lung, and Blood Institute (NHLBI) [R34 HL111492]
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 hearttransplant 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.
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