Efficacy of Psychoeducational Intervention on Allograft Function in Kidney Transplant Patients: 10-Year Results of a Prospective Randomized Study.
Breu-Dejean N, Driot D, et al.Experimental & Clinical Transplantation 2016; 14(1): 38-44.
Aims
To determine whether a psychosocial intervention could improve treatment adherence and therefore 10-year kidney allograft survival rates.
Interventions
Participants were randomized into two groups and received either a psychoeducational intervention every week for 8 weeks (intervention group), or standard care (control group).
Participants
110 kidney transplant recipients aged > 18 years who had received a transplant within the previous 5 years.
Outcomes
The primary outcome measured was allograft survival. Other outcomes measured were serum creatine, immunosuppressant trough levels and adherence score.
Follow-up
10 years
CET Conclusions
This study aimed to investigate the impact of a psychosocial intervention on long term kidney allograft survival. There was no power calculation and on first appearances it would seem that the study would have been too small to detect a significant effect. However, it actually showed a significantly worse allograft survival in the intervention arm (34.5% versus 43.6%) when assessed as absolute values (p=0.02). As a survival analysis the values were just outside the significance level (p=0.06). There is not a very detailed description of the intervention, and it only lasted for 8 weeks at the start of the study; the long term impact of this is questionable. A questionnaire showed increased levels of self-reported adherence in recipients immediately after the intervention. However, the questionnaire scores showed very weak correlation with trough levels of immunosuppression. Ultimately there is no evidence here that implementing an intervention of the kind used in this study could have a positive impact on long term graft survival.
Data analysis
Per protocol analysis
Trial registration
None