Elsevier

Heart & Lung

Volume 30, Issue 4, July–August 2001, Pages 258-268
Heart & Lung

Issues in Pulmonary Care
Use of complementary therapies, adherence, and quality of life in lung transplant recipients*

https://doi.org/10.1067/mhl.2001.116135Get rights and content

Abstract

Purposes: The purpose of this study was to describe complementary and alternative medicine (CAM) use by lung transplant patients and to determine whether CAM users differ from nonusers with respect to health status, quality of life, or medical adherence. Methods: A mailed survey seeking CAM, quality of life, and adherence information was sent to 145 lung transplant recipients, and 99 responded. Results: The majority (88%) used at least 1 form of CAM (median, 2; range, 0-17). Prayer (68%), support groups (43%), and relaxation techniques (31%) were the most common. Only 44% of users reported discussing CAM with their providers. CAM users were adherent to their transplant regimen. Few differences were found between CAM users and nonusers. Education, high symptom burden, female sex, and depression symptoms were associated with various types of CAM use. Conclusion: Most lung transplant recipients are using CAM. Providers must explore potential for interaction or enhancement between CAM and standard therapy to optimize care. (Heart Lung® 2001;30:258-68.)

Section snippets

Patients and procedures

All surviving patients who received a lung or heart/lung transplant at our institution from November 1986 to January 1999 were identified as potential subjects for this study.

A self-report survey, a cover letter, and a self-addressed, stamped, return envelope were mailed to 145 adult heart/lung or lung transplant recipients who had their transplant at least 6 months earlier. Approximately 4 weeks after the survey was mailed, a reminder postcard was sent to all recipients who had not returned

Respondent demographics

Ninety-nine participants completed the survey for a response rate of 68%. As displayed in Table II, the median age of 52.1 years (range, 16-68) is slightly higher than the mean age of 50.7 years because of some fairly young respondents lowering the mean age.

. Characteristics of patient sample (N = 99)

Patient characteristicsFrequency
Current age (median, range)52.1 y, 16-68 y
Sex (male, female)42%, 58%
Marital status (married, single)62%, 38%
Education (n = 97)
 High school or less36.0%
 Some college32.0%
 

Discussion

The primary purpose of this study is to describe the use of complementary and alternative therapies among lung and heart/lung transplant recipients. This was done through a self-report cross-sectional survey mailed to lung and heart/lung recipients from our center. Our response rate of 68% is comparable with that of other mailed surveys of transplant recipients.5

Lung and heart/lung transplant recipients use complementary therapies. Almost 90% of our respondents use at least 1 modality and most

Conclusion

Most lung and heart/lung transplant recipients are using at least 1 complementary or alternative therapy, usually more than 1. We found no differences between CAM users and nonusers in perceived health status, functional status, or adherence to their medical regimen. The last would tend to indicate that persons using CAM were doing so in a complementary nature and the CAM is used as an adjunct and not as a replacement or alternative for the medical regimen.

Future work needs to be done to better

Acknowledgements

We thank the transplant recipients who participated in this study and acknowledge Julie Mielke for her excellent assistance in manuscript preparation.

References (26)

  • T Breidenbach et al.

    Profound drop of Cyclosporin A whole blood trough levels caused by St. John’s Wort (Hypericum perforatum )

    Transplantation

    (2000)
  • B Dossey

    American holistic nurses’ association core curriculum for holistic nursing practice

    (1997)
  • JD Cooper et al.

    A working formulation for the standardization of nomenclature and for clinical staging of chronic dysfunction in lung allografts

    J Heart Lung Transplant

    (1993)
  • Cited by (46)

    • Nonadherence to the medical regimen after lung transplantation: A systematic review

      2017, Heart and Lung: Journal of Acute and Critical Care
      Citation Excerpt :

      Notably, among the articles using self-report measures, a variety of scales were used with most scales having been validated in other chronic diseases or other solid transplant recipients, and their reliability and validity among LTRs was generally unreported.6,22,23,25,26,29,31 Among the 13 articles identified on medication nonadherence, 6 reported associated risk factors for nonadherence.14,21,24,26–28 None of the factors were examined in a sufficient number of articles (i.e., >5) to allow for a meta-analysis.

    • Medication Nonadherence After Lung Transplantation in Adult Recipients

      2017, Annals of Thoracic Surgery
      Citation Excerpt :

      Similarly, nonadherent patients without any adverse consequences are less likely to be detected. Still, the prevalence of more than 10% in the UNOS patient cohort is in line with other reports that range from 4.5% to 26% [9, 12, 15–17]. As a further limitation, information about nonadherence may be poorly reported, was only recorded until December 2006 (not allowing for a more recent analysis) and was not assessed based on severity of nonadherence.

    • Adherence to immunosuppression in adult lung transplant recipients: Prevalence and risk factors

      2011, Journal of Heart and Lung Transplantation
      Citation Excerpt :

      Our initial finding is that we found adherence to immunosuppressive therapy to be high in our study population. The NA rate of 7.7% was lower compared with the NA rates reported by Teichman et al13 and Matthees et al,20 but in those studies adherence was defined as the intake of all medications, not only the primary immunosuppressant, which may have caused higher NA rates. Dew et al15 measured adherence of the primary immunosuppressant.

    • Survival and Quality of Life of Patients Undergoing Lung Transplant

      2011, Clinics in Chest Medicine
      Citation Excerpt :

      The retrospective design, the small cohort size, and other methodological issues limit the interpretation of the results. Multiple studies have provided a strong body of evidence that patients with lung disease severe enough to undergo listing for lung transplant have profoundly reduced quality of life and health-related quality of life (HRQOL).25–60 Although a reasonable amount of published data exist, serious methodological limitations affect the ability to draw well-supported conclusions regarding the effects of lung transplant on quality of life.

    • Creation of a Healing Enhancement Program at an academic medical center

      2007, Complementary Therapies in Clinical Practice
    View all citing articles on Scopus
    *

    Reprint requests: Barbara J. Matthees, MPH, RN, Assistant Professor of Nursing, Minnesota State University Moorhead, 216 Murray Commons, 1104 7th Ave South, Moorhead, MN 56563.

    View full text