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Patient involvement in selection of immunosuppressive regimen following transplantation

Authors Popoola J, Greene H, Kyegombe M, MacPhee IA

Received 15 May 2014

Accepted for publication 12 August 2014

Published 12 December 2014 Volume 2014:8 Pages 1705—1712

DOI https://doi.org/10.2147/PPA.S38987

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Joyce Popoola,1,3 Helen Greene,2 Margaret Kyegombe,2 Iain A MacPhee1,3

1Department of Nephrology and Transplantation, 2Department of Pharmacy, St George’s Healthcare NHS Trust, 3St George’s University of London, London, UK

Abstract: Transplantation has made a considerable difference to the lives of many patients. However, feedback from patients indicates that although having a transplant is a hugely positive experience, having to take medications indefinitely is one of the biggest challenges. An ideal scenario would be no medications following a transplant. A compromise would be a minimal number of medications, with minimal restrictions and as simple a regimen as possible. Although there is considerable research going into fine-tuning the management of the immune response to a transplant, to date there is no universal regimen that enables patients to remain free of immunosuppressant medications, making adherence paramount to maintain long-term allograft survival. This paper reviews the available immunosuppressant regimens and factors influencing choice from both the clinician’s and the patient’s perspective. Factors influencing the decision-making process, such as quality of life for patients, their satisfaction, acceptability, and adherence uptake are reviewed. We conclude with a further assessment of patient choice as a factor in regimen selection, its impact on adherence, and its implications.

Keywords: adherence, transplant, allograft, immunosuppressants, patient involvement, satisfaction, decision-making

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