Variabilidade na adesão aos imunossupressores e demais medicamentos nos receptores de transplante cardíaco em 11 países: estudo descritivo comparativo
Bibliographic record
Abstract
Background: Medication non-adherence (NA) is a prevalent problem between heart transplant recipients. The aim of this study was to describe and compare the prevalence of NA to medication (immunosuppressive and others medication) in 11 countries and 4 continents using data from the BRIGHT study. Method: This was a prelimary secondary data analysis of the BRIGHT study, an internationally, multi-center, cross sectional study in 27 HTx (heart transplant) centers and 11 countries (Australia, Belgium, Brazil, Canada, France, Germany, Italy, Spain, Switzerland, the United Kingdom, United States). 902 adult HTx patients between 1 and 5 year post-Tx were included in this analysis. Non-adherence to immunosuppressant’s and other drugs was assessed using the BAASIS, a self-report instrument assessing different dimensions of medication taking, i.e. taking non-adherence, timing non-adherence (for IS), drug holidays, dose reduction and non-persistence. Non-adherence was assessed for all dimension separately, and for IS as well as overall (i.e. any indication on not taking immunosuppressants correctly over the past 4 weeks) and also by collateral report from clinicians. Data were analyzed using descriptive and inferential statistics. Results: The mean HTx patients’ non-adherence levels were following: taking non-adherence: 16.1% (range: 4.9% Italy – 26.2% USA); timing non-adherence: 27.3% (range: 10% Germany – 42.9% Australia); drug holidays 1.6% (range: 0% France, Germany, Italy, Switzerland, Spain – 6.3% Brazil); dose reduction: 1.4% (range: 0% Australia, Brazil, Germany, Belgium, UK – 4.3% Switzerland); non-persistence: 0.6% (range: 0%-6.3% Brazil); overall non-adherence: 36.4% (range: 17.5% Germany- 57.1% Australia). For other drugs were following: taking non-adherence 20% (range: 7.5% Germany – 32.6% USA); drug holidays 4.6% (range: 0% Germany – 12.5% Brazil); dose reduction 3.9% (range: 0% Germany and UK – 12.5% Brazil); non-persistence 2.1% (range: 0% Brazil, Germany, Italy, Switzerland, Uk – 5.9% Canada). Conclusion: The observed variability in HTx patients’ non-adherence to immunosuppressant’s and other drugs across countries suggests that health care system factors play a role in explaining HTx patient’s non-adherence (e.g. drug coverage).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.097 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".