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Non-adherence to immunosuppressants following renal transplantation: a protocol for a systematic review

INTRODUCTION: Adherence to immunosuppressant medication is essential for renal transplant recipients. This review aims to summarise what is known about non-adherence, with a view to providing comprehensive evidence to inform strategies aimed at advancing adherent behaviour. METHODS AND ANALYSIS: A s...

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Autores principales: Hucker, Abigail, Bunn, Frances, Carpenter, Lewis, Lawrence, Christopher, Farrington, Ken, Sharma, Shivani
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5640118/
https://www.ncbi.nlm.nih.gov/pubmed/28963283
http://dx.doi.org/10.1136/bmjopen-2016-015411
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author Hucker, Abigail
Bunn, Frances
Carpenter, Lewis
Lawrence, Christopher
Farrington, Ken
Sharma, Shivani
author_facet Hucker, Abigail
Bunn, Frances
Carpenter, Lewis
Lawrence, Christopher
Farrington, Ken
Sharma, Shivani
author_sort Hucker, Abigail
collection PubMed
description INTRODUCTION: Adherence to immunosuppressant medication is essential for renal transplant recipients. This review aims to summarise what is known about non-adherence, with a view to providing comprehensive evidence to inform strategies aimed at advancing adherent behaviour. METHODS AND ANALYSIS: A systematic review of quantitative studies that report adherence to immunosuppressants in adult (over 18 years) renal transplant recipients. The review will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines; study quality will be assessed using the Downs and Black checklist. Systematic searches will be completed across relevant databases. Two reviewers will independently extract data using a predefined data extraction form. We will summarise the operationalisation of adherence across studies and use narrative synthesis to identify factors associated with non-adherence. A meta-analysis will be conducted if there is sufficient homogeneity, and available data, across studies to estimate the prevalence of non-adherence in renal transplant recipients. Heterogeneity will be assessed using the I(2) test. Survival analysis will be conducted to estimate hazard ratios to explore the impact of non-adherence on graft survival, graft failure and patient survival. ETHICS AND DISSEMINATION: Findings will be published in a peer-reviewed journal and disseminated at conferences for professionals and researchers. Review outcomes will help support clinical practice by highlighting the extent of non-adherence among adults, and in doing so, signpost the need for suitable intervention. TRIAL REGISTRATION NUMBER: PROSPERO registration number (CRD42016038751).
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spelling pubmed-56401182017-10-19 Non-adherence to immunosuppressants following renal transplantation: a protocol for a systematic review Hucker, Abigail Bunn, Frances Carpenter, Lewis Lawrence, Christopher Farrington, Ken Sharma, Shivani BMJ Open Renal Medicine INTRODUCTION: Adherence to immunosuppressant medication is essential for renal transplant recipients. This review aims to summarise what is known about non-adherence, with a view to providing comprehensive evidence to inform strategies aimed at advancing adherent behaviour. METHODS AND ANALYSIS: A systematic review of quantitative studies that report adherence to immunosuppressants in adult (over 18 years) renal transplant recipients. The review will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines; study quality will be assessed using the Downs and Black checklist. Systematic searches will be completed across relevant databases. Two reviewers will independently extract data using a predefined data extraction form. We will summarise the operationalisation of adherence across studies and use narrative synthesis to identify factors associated with non-adherence. A meta-analysis will be conducted if there is sufficient homogeneity, and available data, across studies to estimate the prevalence of non-adherence in renal transplant recipients. Heterogeneity will be assessed using the I(2) test. Survival analysis will be conducted to estimate hazard ratios to explore the impact of non-adherence on graft survival, graft failure and patient survival. ETHICS AND DISSEMINATION: Findings will be published in a peer-reviewed journal and disseminated at conferences for professionals and researchers. Review outcomes will help support clinical practice by highlighting the extent of non-adherence among adults, and in doing so, signpost the need for suitable intervention. TRIAL REGISTRATION NUMBER: PROSPERO registration number (CRD42016038751). BMJ Publishing Group 2017-09-28 /pmc/articles/PMC5640118/ /pubmed/28963283 http://dx.doi.org/10.1136/bmjopen-2016-015411 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Renal Medicine
Hucker, Abigail
Bunn, Frances
Carpenter, Lewis
Lawrence, Christopher
Farrington, Ken
Sharma, Shivani
Non-adherence to immunosuppressants following renal transplantation: a protocol for a systematic review
title Non-adherence to immunosuppressants following renal transplantation: a protocol for a systematic review
title_full Non-adherence to immunosuppressants following renal transplantation: a protocol for a systematic review
title_fullStr Non-adherence to immunosuppressants following renal transplantation: a protocol for a systematic review
title_full_unstemmed Non-adherence to immunosuppressants following renal transplantation: a protocol for a systematic review
title_short Non-adherence to immunosuppressants following renal transplantation: a protocol for a systematic review
title_sort non-adherence to immunosuppressants following renal transplantation: a protocol for a systematic review
topic Renal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5640118/
https://www.ncbi.nlm.nih.gov/pubmed/28963283
http://dx.doi.org/10.1136/bmjopen-2016-015411
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