Differences in patient and transplant professional perceptions of immunosuppression-induced cosmetic side effects

Differences in patient and transplant professional perceptions of immunosuppression-induced cosmetic side effects

A two-part study was initiated to compare kidney transplant patient and transplant professional perceptions regarding immunosuppression-related physical changes and their impact on transplant recipients. Parallel surveys were developed and administered to transplant patients and active transplant cl...

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Bibliographic Details
Published in:Transplantation Vol. 78; no. 4; pp. 537 - 543
Main Authors: PETERS, Thomas G, SPINOLA, Kristin N, WEST, John C, AEDER, Mark I, DANOVITCH, Gabriel M, KLINTMALM, Goran B. G, GORMAN, Kevin J, GORDON, John A, KINCAID, Carl H, FIRST, M. Roy
Format: Journal Article
Language:English
Published: Hagerstown, MD Lippincott 27-08-2004
Subjects:
Alopecia - chemically induced
Biological and medical sciences
Combined surgery. Multiple transplantations
Communication
Female
Gingival Hyperplasia - chemically induced
Hirsutism - chemically induced
Humans
Immunosuppressive Agents - adverse effects
Kidney Transplantation - adverse effects
Male
Medical sciences
Perception
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Cosmetic
Human
Graft(material)
Toxicity
Transplantation
Homotransplantation
Immunosuppression
Treatment
Surgery
Secondary effect
Graft
Perception
Comparative study
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Summary:A two-part study was initiated to compare kidney transplant patient and transplant professional perceptions regarding immunosuppression-related physical changes and their impact on transplant recipients. Parallel surveys were developed and administered to transplant patients and active transplant clinicians. Eighty percent of surveyed patients reported immunosuppression-induced hirsutism, gingival hyperplasia, acne, alopecia, or cushingoid facies. Hirsutism (94%) and gingival hyperplasia (51%) occurred more frequently in cyclosporine patients (p < 0.01); alopecia (30%) occurred more frequently in tacrolimus patients (p < 0.01). Patient reported incidence of physical changes significantly exceeded observations by professionals for every condition (p < 0.01), however 84.4% of affected patients reported feeling "happy to endure" changes "for the sake of having a transplant." Patients also reported emotional and social effects due to physical changes, an outcome underestimated by transplant professionals (p < 0.01). Patients and professionals communicated about physical changes; however, more than half of affected patients believed communication occurred "rarely/never" while over half of the professionals believed communication occurred "every visit/most of the time." Although most physicians believed changes could be addressed, doctors recommended treatment for less than half of the affected patients. When recommended therapy changes were pursued, treatments were effective in the majority of cases. Incidence of immunosuppression-related physical changes is high and somewhat dependent on drug regimen. Although patients seem willing to accept cosmetic changes for the sake of having a transplant, physical changes have a psychosocial impact that is underestimated by clinicians. Immunosuppression-related physical changes remain underaddressed; effective interventions offer opportunities for improved care.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
content type line 23
ISSN:0041-1337
1534-6080
DOI:10.1097/01.TP.0000139253.30998.57