Understanding Beliefs About and Barriers to Adherence in Pediatric Cardiology Transplant Recipients

Adrianna Damato, Fordham University


Closely adhering to medication regimens following solid organ transplantation is essential for recipients. Research demonstrates that nonadherence in pediatric transplant recipients is consistently the greatest risk factor for graft rejection, adverse outcomes in general, and death (Lurie, Shemesh, & Shiener, 2000). To address nonadherence, efforts have focused on investigating its correlates and risk factors. However, few studies investigate psychological correlates of nonadherence in the pediatric heart transplant population (Griffin & Elkin, 2000). Nonadherence is extremely common among pediatric transplant recipients, especially during transition to adulthood. At this point in life, medication management becomes crucial for recipients. Preparedness, perceptions, expectations, and other factors have been found to contribute to the transition process (Anthony et al., 2009). During adolescence, recipients experience an array of developmental experiences while shifting from reliance on their caregivers to manage medications. Therefore, it is important to learn what psychosocial variables may influence a recipient’s abilities to manage their health care needs from adolescence through the transition to adulthood. Little research focuses on the effect of a patient’s perception of their illness on adherence outcomes. While research has separately investigated the determinants of nonadherence and the psychological impact of transplantation on adolescents, more work needs to be done to investigate the psychological impact of cardiac illness on adherence. By examining how an individual views their conditions, researchers can design interventions to facilitate the coping process. Seven adolescents from Mount Sinai’s Pediatric Heart Transplant Clinic participated in a single testing session. Patients were between the ages of 11 and 18, received a heart transplant at least six months ago, and prescribed tacrolimus as part of their post-transplant immunosuppressant regimen. Patients were presented with a packet of constructs and measures assessing beliefs surrounding their illness and attitudes towards medications.

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Recommended Citation

Damato, Adrianna, "Understanding Beliefs About and Barriers to Adherence in Pediatric Cardiology Transplant Recipients" (2018). ETD Collection for Fordham University. AAI10822561.