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The Barriers Assessment Tool—A Patient-Centered Measure of Adherence Barriers in Pediatric Kidney Transplantation

Objective: Assessing barriers to adherence provides helpful information to clinicians. The objective of this study was to describe the clinical utility of the Barriers Assessment Tool (BAT) using clinical data for a large, midwestern U.S. pediatric kidney transplant program. Methods: Focus group and...

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Autores principales: Varnell, Charles D., Hooper, David K., Mara, Constance A., Modi, Avani C., Rich, Kristin L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10527691/
https://www.ncbi.nlm.nih.gov/pubmed/37761394
http://dx.doi.org/10.3390/children10091435
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author Varnell, Charles D.
Hooper, David K.
Mara, Constance A.
Modi, Avani C.
Rich, Kristin L.
author_facet Varnell, Charles D.
Hooper, David K.
Mara, Constance A.
Modi, Avani C.
Rich, Kristin L.
author_sort Varnell, Charles D.
collection PubMed
description Objective: Assessing barriers to adherence provides helpful information to clinicians. The objective of this study was to describe the clinical utility of the Barriers Assessment Tool (BAT) using clinical data for a large, midwestern U.S. pediatric kidney transplant program. Methods: Focus group and clinical data were obtained during post-transplant medical visits. Qualitative and quantitative assessment methods were utilized to describe patient and caregiver feedback on the BAT, clinical utility, concordance between reporters, and the effect of interventions on subsequent assessment and electronically measured adherence. Results: Patients were willing to discuss adherence issues with their care team. There was substantial agreement between patients and caregivers at two timepoints. If a barrier was not addressed, 89.6% (43/48) of patients and 85.9% (67/78) of caregivers reported the same BAT scores from the first to second assessment. When barriers were addressed with a clinic-based intervention, 82% of caregivers reported no adherence barriers. No significant change was found for patient-reported barriers. Conclusions: Standardized assessment of barriers to medication adherence provides actionable information to clinicians. Standardized assessment of adherence barriers may give clinicians opportunities to help patients and caregivers overcome these barriers which can decrease risk of rejection.
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spelling pubmed-105276912023-09-28 The Barriers Assessment Tool—A Patient-Centered Measure of Adherence Barriers in Pediatric Kidney Transplantation Varnell, Charles D. Hooper, David K. Mara, Constance A. Modi, Avani C. Rich, Kristin L. Children (Basel) Article Objective: Assessing barriers to adherence provides helpful information to clinicians. The objective of this study was to describe the clinical utility of the Barriers Assessment Tool (BAT) using clinical data for a large, midwestern U.S. pediatric kidney transplant program. Methods: Focus group and clinical data were obtained during post-transplant medical visits. Qualitative and quantitative assessment methods were utilized to describe patient and caregiver feedback on the BAT, clinical utility, concordance between reporters, and the effect of interventions on subsequent assessment and electronically measured adherence. Results: Patients were willing to discuss adherence issues with their care team. There was substantial agreement between patients and caregivers at two timepoints. If a barrier was not addressed, 89.6% (43/48) of patients and 85.9% (67/78) of caregivers reported the same BAT scores from the first to second assessment. When barriers were addressed with a clinic-based intervention, 82% of caregivers reported no adherence barriers. No significant change was found for patient-reported barriers. Conclusions: Standardized assessment of barriers to medication adherence provides actionable information to clinicians. Standardized assessment of adherence barriers may give clinicians opportunities to help patients and caregivers overcome these barriers which can decrease risk of rejection. MDPI 2023-08-23 /pmc/articles/PMC10527691/ /pubmed/37761394 http://dx.doi.org/10.3390/children10091435 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Varnell, Charles D.
Hooper, David K.
Mara, Constance A.
Modi, Avani C.
Rich, Kristin L.
The Barriers Assessment Tool—A Patient-Centered Measure of Adherence Barriers in Pediatric Kidney Transplantation
title The Barriers Assessment Tool—A Patient-Centered Measure of Adherence Barriers in Pediatric Kidney Transplantation
title_full The Barriers Assessment Tool—A Patient-Centered Measure of Adherence Barriers in Pediatric Kidney Transplantation
title_fullStr The Barriers Assessment Tool—A Patient-Centered Measure of Adherence Barriers in Pediatric Kidney Transplantation
title_full_unstemmed The Barriers Assessment Tool—A Patient-Centered Measure of Adherence Barriers in Pediatric Kidney Transplantation
title_short The Barriers Assessment Tool—A Patient-Centered Measure of Adherence Barriers in Pediatric Kidney Transplantation
title_sort barriers assessment tool—a patient-centered measure of adherence barriers in pediatric kidney transplantation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10527691/
https://www.ncbi.nlm.nih.gov/pubmed/37761394
http://dx.doi.org/10.3390/children10091435
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