The relation between psychological distress and medication adherence in lung transplant candidates and recipients: A cross-sectional study.
Marion J Wessels-Bakker, Eduard A van de Graaf, Johanna M Kwakkel-van Erp and 3 others
PMID 34216066WHAT IT FOUND
Lung transplant patients reported high distress and medication non-adherence.
In recipients, anxiety symptoms were linked to better adherence; depression and PTSD were not. Ask about anxiety and timing problems, but do not assume cause.
Key findings
01In lung transplant recipients, (sub)clinical anxiety symptoms were significantly related to medication adherence (p = .048), and anxious recipients were two times more likely to be adherent than non-anxious recipients.
02Medication non-adherence was common: 36% of candidates and 41% of recipients were categorised as non-adherent.
03Clinical depression in candidates was four times higher than the general population, and anxiety was four times higher in candidates and almost three times higher in recipients.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study used screening questionnaires, not diagnostic interviews, so it reports symptoms rather than confirmed depression, anxiety or PTSD diagnoses. The cross-sectional design cannot show whether anxiety affects adherence, adherence affects anxiety, or both are driven by another factor. Medication adherence was self-reported with a deliberately strict instrument, so the reported non-adherence rates may not match actual medication-taking. It was a single centre, and candidates and recipients differed in education, employment and primary lung disease, so generalisation may be limited. The authors did not analyse whether time on the waiting list or time since transplantation affected outcomes.
Declared interests
The authors declared no conflict of interest and reported no funding for the study.
The easy way to misread this
Do not conclude that anxiety makes patients adhere better. The association was cross-sectional and measured at one time point, so it cannot show cause, and adherence was assessed by a strict self-report instrument.