Improving immunosuppressant medication compliance management in adult kidney transplant patients: an evidence-based practice project.
6 affiliations
- 1Shulan International Medical College, Zhejiang Shuren University, Hangzhou, PR China.
- 2Institute of AI-Empowered Full Lifecycle Care, Zhejiang Shuren University, Hangzhou, 310015, China.
- 3Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren University, Hangzhou, PR China.
- 4Zhejiang Shuren University, Hangzhou, PR China.
- 5Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren University, Hangzhou, PR China. [email protected].
- 6Zhejiang Shuren University, Hangzhou, PR China. [email protected].
Abstract
Background
The proper use of immunosuppressants is critical for the long-term survival of kidney transplant recipients. Therefore, it is necessary to study strategies to promote the management of immunosuppressant medication adherence in adult kidney transplant patients.Objective
This project aims to improve the immunosuppressant medication adherence management system in adult kidney transplant recipients by implementing evidence-based best practices.Methods
This evidence-based implementation project was conducted in a kidney transplant center in China. It included a baseline audit, two implementation rounds, and two follow-up audits. In the preliminary phase, the research team had summarized 38 pieces of best evidence on immunosuppressant medication adherence management. For the clinical application phase, a multidisciplinary expert panel prioritized 18 recommendations and translated them into 23 measurable evidence-based audit criteria, including structural, process, and outcome criteria. Audits were conducted at baseline and after two implementation rounds. The healthcare personnel samples were 71 at baseline, 70 in the first follow-up audit, and 69-80 in the second follow-up audit. Patient-level audit samples varied by criterion, ranging from 35 to 82 at baseline, 30-71 in the first follow-up audit, and 31-80 in the second follow-up audit. Barriers and facilitators were systematically analyzed to develop and refine implementation strategies across both rounds.Results
Barrier analysis informed the development and refinement of targeted implementation strategies across both rounds. At baseline, 15 of the 23 audit criteria had compliance rates below 60%. After the first round of implementation, only 6 criteria had a compliance rate below 90%. After the second round, all 23 criteria achieved a compliance rate of 90% or higher. From a system perspective, a multidisciplinary team (MDT) for managing immunosuppressant medication adherence was established and improved. The management system, specific processes, and evaluation standards were revised, and 7 information system improvement projects were completed.Conclusion
The evidence-based implementation project for managing immunosuppressant medication adherence in kidney transplant patients, based on best evidence, was successfully carried out. However, the clinical outcomes and sustainability of the audit criteria have yet to be evaluated, which requires further research.
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BibTeX
@article{shen2026improving,
title = {{Improving immunosuppressant medication compliance management in adult kidney transplant patients: an evidence-based practice project.}},
author = {Mingyan Shen and Linqiu Han and Rufen Shen and Zhixian Feng},
journal = {BMC nursing},
year = {2026},
month = aug,
doi = {10.1186/s12912-026-04946-9},
url = {https://europepmc.org/article/MED/42972352},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Improving immunosuppressant medication compliance management in adult kidney transplant patients: an evidence-based practice project.
AU - Mingyan Shen
AU - Linqiu Han
AU - Rufen Shen
AU - Zhixian Feng
PY - 2026
DA - 2026/08/05
JO - BMC nursing
DO - 10.1186/s12912-026-04946-9
UR - https://europepmc.org/article/MED/42972352
AB - Background The proper use of immunosuppressants is critical for the long-term survival of kidney transplant recipients. Therefore, it is necessary to study strategies to promote the management of immunosuppressant medication adherence in adult kidney transplant patients.Objective This project aims to improve the immunosuppressant medication adherence management system in adult kidney transplant recipients by implementing evidence-based best practices.Methods This evidence-based implementation project was conducted in a kidney transplant center in China. It included a baseline audit, two implementation rounds, and two follow-up audits. In the preliminary phase, the research team had summarized 38 pieces of best evidence on immunosuppressant medication adherence management. For the clinical application phase, a multidisciplinary expert panel prioritized 18 recommendations and translated them into 23 measurable evidence-based audit criteria, including structural, process, and outcome criteria. Audits were conducted at baseline and after two implementation rounds. The healthcare personnel samples were 71 at baseline, 70 in the first follow-up audit, and 69-80 in the second follow-up audit. Patient-level audit samples varied by criterion, ranging from 35 to 82 at baseline, 30-71 in the first follow-up audit, and 31-80 in the second follow-up audit. Barriers and facilitators were systematically analyzed to develop and refine implementation strategies across both rounds.Results Barrier analysis informed the development and refinement of targeted implementation strategies across both rounds. At baseline, 15 of the 23 audit criteria had compliance rates below 60%. After the first round of implementation, only 6 criteria had a compliance rate below 90%. After the second round, all 23 criteria achieved a compliance rate of 90% or higher. From a system perspective, a multidisciplinary team (MDT) for managing immunosuppressant medication adherence was established and improved. The management system, specific processes, and evaluation standards were revised, and 7 information system improvement projects were completed.Conclusion The evidence-based implementation project for managing immunosuppressant medication adherence in kidney transplant patients, based on best evidence, was successfully carried out. However, the clinical outcomes and sustainability of the audit criteria have yet to be evaluated, which requires further research.
SN - 1472-6955
ER -