Adesão à terapêutica imunossupressora no pós transplante renal: implementação das melhores práticas

Abstract

Kidney transplantation is a treatment modality that requires immunosuppressive therapy in order to prevent graft rejection and improve patient survival. The objective of this study was to assess immunosuppressive adherence and promote the implementation of best practices for its expansion after renal transplantation in an outpatient clinic. It is a quasi-experimental intervention type study, before and after, following the methodology of implementing scientific evidence in JBI clinical practice. This methodology is based on a clinical audit process that comprises the baseline audit phase, implementation of best practices and follow-up auditing. The audited topic was “Kidney transplantation in adults: interventions to improve medication adherence”, which had eight criteria to be evaluated. To check adherence to immunosuppressants, the triangulation method was used, composed of patients' self-reports, classification of adherence by professionals and results of serum levels of immunosuppressants. The study found that out of the eight criteria audited, four were in full compliance with the literature in the research scenario, two of which were completely non-compliant. In this context, strategies to improve non-conformities were planned and implemented. Regarding the measurement of patients' immunosuppressive adherence, the result was a rate of 90% of patients classified as adherent both in the pre-intervention and in the post-intervention phase, demonstrating the quality and commitment of the outpatient service patients.