The transplant team's support of kidney transplant recipients to take their prescribed medications: a collective responsibility.

Williams, Allison, Low, Jac Kee, Manias, Elizabeth and Crawford, Kimberley 2016, The transplant team's support of kidney transplant recipients to take their prescribed medications: a collective responsibility., Journal of clinical nursing, vol. 25, no. 15-16, pp. 2251-2261, doi: 10.1111/jocn.13267.

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Title The transplant team's support of kidney transplant recipients to take their prescribed medications: a collective responsibility.
Author(s) Williams, Allison
Low, Jac Kee
Manias, ElizabethORCID iD for Manias, Elizabeth
Crawford, Kimberley
Journal name Journal of clinical nursing
Volume number 25
Issue number 15-16
Start page 2251
End page 2261
Total pages 11
Publisher Wiley
Place of publication London, Eng
Publication date 2016-08
ISSN 1365-2702
Keyword(s) communication
end-stage kidney disease
kidney transplantation
medication adherence
Summary AIMS AND OBJECTIVES: To obtain an understanding of how health professionals support the kidney transplant patient to take their medications as prescribed long term. BACKGROUND: Kidney transplantation requires stringent adherence to complex medication regimens to prevent graft rejection and to maintain general well-being. Medication nonadherence is common in kidney transplantation, emerging in the first few months post-transplantation, leading to poor patient outcomes. DESIGN: Exploratory qualitative design. METHODS: Five focus groups were conducted with a total of seven renal nurse transplant coordinators, two renal transplant nurse unit managers, seven nephrologists, seven pharmacists, four social workers, and one consumer representative representing all five hospitals offering adult kidney transplantation in Victoria, Australia in 2014. The views of two general practitioners who were unable to attend the focus groups were incorporated into the data set. All data underwent thematic analysis. RESULTS: Analysis revealed that adherence was a collective responsibility involving the whole of the transplant team and the patient via education blitz in hospital, identifying and managing nonadherence, promotion of self-advocacy, and the partnership between the patient and health professional. Patients were directed how to take their complex medications to be self-empowered, yet the partnership between the patient and health professional limited the patient's voice. CONCLUSION: Although medication adherence was a collective responsibility, communication was often one-way chiefly as a result of staffing and time constraints, hindering effective partnerships necessary for medication adherence. Expert skills in communication and adherence counselling are necessary to identify barriers affecting medication adherence. Patients need to be systematically screened, prepared and supported long-term within an accommodating healthcare system for the reality of caring for their transplanted kidney. RELEVANCE TO CLINICAL PRACTICE: Kidney transplant recipients require systematic preparation and quality long-term follow-up to adhere to their prescribed medications.
Language eng
DOI 10.1111/jocn.13267
Field of Research 1110 Nursing
1701 Psychology
Socio Economic Objective 929999 Health not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Wiley
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