Abstract:

Objective To search，evaluate and summarize the best evidence on the management of immunosuppressive drug adherence in adult renal transplant recipients，so as to provide references to clinical decision making. Methods BMJ Best Practice，UpToDate，British Nephrology Association，Organization for Improving the Prognosis of Global Nephropathy，American Association of Intensive Care Nurses，Medical Pulse，Mays Medicine，Chinese Medical Association Organ Transplantation Credit Association and other websites，Joanna Briggs Institute of Australia evidence-based health care center database，Cochrane Library，Embase，EBSCO，Web of Science，PubMed，China Biomedical Database，CNKI，Wanfang were searched by the computer. Guidelines，evidence summaries，best practices，expert consensuses，systematic reviews on the assessment of adherence to immunosuppressive drugs and management of interventions in renal transplant recipients were retrieved. The time for the search was from database creation to July 31，2022. Literature quality evaluation and data extraction was performed by 2 investigators. Results A total of 13 articles were involved，including 2 guidelines，1 evidence summary，4 expert consensuses，3 systematic reviews and 3 meta-analyses. 38 pieces of best evidence were generated in 3 areas，namely healthcare worker training，adherence assessment，and adherence intervention. Conclusion The results of this study could assist nurses to manage adherence to immunosuppressant medication in renal transplant recipients and provide an evidence-based basis for improving the quality of transplant care.

Key words: Renal Transplantation, Medication Adherence, Immunosuppressant, Evidence Summary, Evidence-Based Nursing

摘要：

目的 检索、评价和汇总成人肾移植患者免疫抑制剂服药依从性管理的证据，为临床决策提供参考。 方法 计算机检索BMJ Best Practice、UpToDate、英国肾脏病协会、改善全球肾脏病预后组织、美国重症监护护士协会、医脉通、梅斯医学、中华医学会器官移植学分会等网站和澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、Cochrane Library、Embase、EBSCO、Web of Science、PubMed、中国生物医学数据库、中国知网、万方数据库等数据库。检索关于肾移植患者免疫抑制剂服药依从性评估及干预管理的指南、证据总结、最佳实践、专家共识、系统评价。检索时限为建库至2022年7月31日。由2名研究者进行文献质量评价和资料提取。 结果 共纳入13篇文献，包括2篇指南、1篇证据总结、4篇专家共识、3篇系统评价和3篇Meta分析。围绕医护人员培训、依从性评估、依从性干预3个方面形成38条证据。 结论 该研究总结的肾移植患者免疫抑制剂服药依从性管理的证据比较全面、科学，可协助临床医护人员制订肾移植患者免疫抑制剂服药依从性评估和干预方案，为提升移植照护质量提供循证依据。

关键词: 肾移植, 服药依从性, 免疫抑制剂, 证据总结, 循证护理学