Banca de QUALIFICAÇÃO: LUANA CRISTINA LINS DE MEDEIROS OLIVEIRA

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : LUANA CRISTINA LINS DE MEDEIROS OLIVEIRA
DATE: 14/03/2024
TIME: 09:00
LOCAL: Link de acesso para videoconferência: https://meet.google.com/sht-cugk-kmp
TITLE:

Development and Internal Validation of a Questionnaire Assessing Predisposition to Nonadherence to Immunosuppressive Medication in Kidney Pretransplant Patients


KEY WORDS:
kidney transplant; medication non-adherence; immunosuppressive therapy; psychometric scale, factor analysis, questionnaire design, reliability and validity.

PAGES: 145
BIG AREA: Ciências da Saúde
AREA: Farmácia
SUMMARY:
Introduction: Non-adherence to immunosuppressive therapy after kidney
transplantation is an important factor for rejection and graft loss. Identifying
nonadherence related to use of immunosuppressants is essential for treatment,
however, it is not uncommon for this to occur with irreparable damage to the graft.
Therefore, the prior identification of patients susceptible to this non-adherence would
enable the adoption of preventive measures. However, clinical instruments have not
yet been developed for this purpose. Objective: To develop and validate a
psychometric scale for the assessment of propensity to non-adherence to
immunosuppressant therapy in pre-kidney transplant patients. Methodology:
Multicenter, prospective, observational, longitudinal and analytical study in candidate
patients for kidney transplant of both sexes, over 18 years old. To develop the
psychometric scale, a set of items expressing patient statements were compiled,
obtained through a literature review, focus group and an expert panel. The pilot
questionnaire was administered to 541 patients from 13 healthcare centers, of which
154 repeated the questionnaire approximately 12 months later. The final
questionnaire was obtained by exploratory factor analysis and internal validation
included analysis of internal consistency reliability, test-retest reliability and
convergent validity assessed by differentiation by known groups. For external
validation, 381 patients with already scheduled surgery were included in six
transplant centers and were observed in the pre-transplant and in months 3, 6 and 12
post-transplant for evaluation of criterion validity, by comparison with two medication
non-adherence scales, and validity predictive of non-adherence, assessed by a
combination of 3 methods (self-report, serum level of immunosuppressants and drug
withdrawal from the pharmacy). Results: The final questionnaire, called Kidney
AlloTransplant Immunosuppression Therapy Adherence (KATITA) Questionnaire,
consisting of 25 items in 3 uncorrelated dimensions, showed good internal
consistency reliability (Cronbach's alpha 0.81). The 3 dimensions and respective
Cronbach's alpha were “Carelessness” (14 items, 0.81), “Skepticism” (6 items, 0.57)
and “Concern” (5 items, 0.62). Test-retest reliability showed an intraclass correlation
coefficient of 0.62 (moderate agreement). The scale showed convergent validity. The
longitudinal study included 381 patients and confirmed the multidimensional structure
of the scale and criterion validity. The predictive validity of the scale was confirmed by an area under the ROC curve of 0.68, sensitivity of 59,8%, specificity of 68,2%,
and positive predictive value of 71,8%. Conclusion: The KATITA-25 questionnaire is
the first validated psychometric questionnaire assessing predisposition to non
adherence to immunosuppressive medication in candidate patients to kidney
transplantation in the pre-kidney transplant setting.

COMMITTEE MEMBERS:
Interna - 2323511 - ADRIANA AUGUSTO DE REZENDE
Externo ao Programa - 572904 - JOSE BRUNO DE ALMEIDA - nullPresidente - 2275890 - MARCELO DE SOUSA DA SILVA
Notícia cadastrada em: 08/02/2024 15:16
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