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Adherence to laboratory testing in pediatric liver transplant recipients
Author(s) -
Ryan Jamie L.,
Dandridge Laura M.,
Fischer Ryan T.
Publication year - 2021
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13899
Subject(s) - medicine , liver transplantation , retrospective cohort study , transplantation , cohort , liver disease , adverse effect , emergency medicine , pediatrics , intensive care medicine
Background The objectives of this retrospective cohort study are to describe rates of adherence to laboratory testing 6 months to 3 years post–liver transplantation and to examine demographic and clinical factors related to lab non‐adherence and the association with medication adherence and clinical outcomes. Methods Medical chart review was conducted for 54 youth (mean age = 5.0 years) transplanted between 2003 and 2014. Lab adherence (≥80%) was measured as the proportion of completed labs out of the number expected. Immunosuppressant drug‐level variability was used as a proxy for medication adherence. Clinical outcomes included LAR, viral infection, hospitalization, and non‐routine clinic visit ≥12 months after transplant. Results Lab adherence decreased substantially over time. Single‐parent household (aOR 5.86; 95% CI: 1.38‐24.93) and no history of early rejection (aOR 3.96; 95% CI: 1.04‐15.24) were independently associated with non‐adherence. Lab non‐adherence was significantly associated with medication non‐adherence ( P < .05), LAR ( P = .02), and non‐routine clinic visits ( P = .03). Conclusions Systematic monitoring of lab adherence may help in identifying pediatric LT recipients at increased risk for excessive healthcare use and adverse outcomes possibly due to poor disease management.