腎移植患者の健康習慣と服薬アドヒアランスおよび腎機能とQOLの関連

The Relationship between Health Habits, Medication Adherence, Kidney Function, and QOL among Kidney Transplant Patients

要旨

目的：腎移植患者の健康習慣，服薬アドヒアランスおよび腎機能とQOLの関連について検討すること．

方法：腎移植患者238名を対象とし，自記式質問紙調査では，健康関連QOLを評価するためにSF-36v2，健康習慣を評価するために6つの健康習慣，服薬アドヒアランスを評価するために日本語版MMAS-8を測定した．電子カルテデータの収集は，分析対象者の基本属性，腎機能（eGFR値）を把握した．

結果：分析対象者142名のうち，健康習慣が良好である群と服薬アドヒアランスの高い群は，精神的QOLが高かった．混合効果モデルの結果，精神的QOLが高いことを有意に説明した要因は，良好な健康習慣，年齢，高い服薬アドヒアランス，肥満度であった．

結論：腎移植患者のQOL向上のために，良好な健康習慣と適切な服薬継続が実践・継続できるよう長期的な支援体制を構築する必要性が示唆された．

Aim: The purpose of this study is to examine the health habits, medication adherence, renal function and the relationship between quality of life (QOL) among renal transplant patients.

Methods: The participants were 238 patients who had undergone renal transplantation. Healthrelated QOL was measured using the self-administered Medical Outcomes Study 36-Item Short-Form Health Survey, health habits were examined using questions on six health-related habits, and medication adherence was measured using the Japanese version of Morisky Medication Adherence Scale-8. Participant characteristics and renal function data were obtained from the patients' electronic medical record data.

Results: Among the 142 participants whose data were analyzed, those with good health habits or high level of medication adherence were more likely to have mental QOL. A mixed effect model showed that mental quality of life was significantly explained by good health habits, aging, high level of medication adherence, and high degree of obesity calculated from body mass index.

Conclusion: The results suggest that a long-term support system in outpatient care settings might facilitate good health habits and appropriate medication adherence among patients who have undergone renal transplantation, in order to improve or maintain their QOL.