Evidence map›Paper›PMID 34216066›Full record

ArticleJournal of clinical nursing2022

The relation between psychological distress and medication adherence in lung transplant candidates and recipients: A cross-sectional study.

Marion J Wessels-Bakker, Eduard A van de Graaf, Johanna M Kwakkel-van Erp, Harry G Heijerman, Wiepke Cahn, Renske Schappin

Erratum issuedOpen access · hybridAbstract read
In one paragraph

Article in Journal of clinical nursing, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Exploring Factors Associated with Sleep Quality After Lung Transplantation.Progress in transplantation (Aliso Viejo, Calif.) · 2025
    Trial
  3. Trial
  4. Review
  5. Article
  6. Article
  7. Article
  8. Review
  9. The Critical Role of Mental Health Specialists in Organ Transplantation Teams: An ELPAT Position Statement.Transplant international : official journal of the European Society for Organ Transplantation · 2026
    Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Journal of clinical nursing · 2022
    Article
  15. Article
  16. Article
  17. Article
4 · The record

Corrections and comments

  • Erratum issued
    2022
5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Marion J Wessels-BakkerDepartment of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.ORCID https://orcid.org/0000-0003-3514-5384
Eduard A van de GraafDepartment of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
Johanna M Kwakkel-van ErpDepartment of Pulmonology, University Hospital Antwerp and University of Antwerp, Edegem, Belgium.ORCID https://orcid.org/0000-0002-7558-1239
Harry G HeijermanDepartment of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
Wiepke CahnDepartment of Mental Health, University Medical Center Utrecht, Utrecht, The Netherlands.ORCID https://orcid.org/0000-0002-0482-8759
Renske SchappinDepartment of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.ORCID https://orcid.org/0000-0002-5727-5852
University Medical Center Utrecht · NLUniversity of Antwerp · BEUtrecht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

AIMS AND

objectivesTo explore the prevalence of psychological distress such as anxiety, depression and post-traumatic stress disorder and its associations with medication adherence in lung transplant patients.

backgroundPsychological distress after lung transplantation may impact clinical outcomes by associated behaviours such as non-adherence to medication. Evidence about the relation between psychological distress and medication adherence in lung transplant patients is limited and not well explained. DESIGN AND

methodsWe conducted a single-centre study with a cross-sectional design in 73 lung transplant candidates and 116 recipients. Questionnaires were the Brief Symptom Inventory, Impact of Event Scale and Basel Assessment of Adherence to Immunosuppressive Medications Scale. The STROBE checklist was monitored.

resultsIn candidates, 39.7% reported (sub)clinical symptoms of depression, in recipients this was 21.6%. We observed suicidal ideation in recipients (8.6%), and candidates (5.5%). The prevalence of (sub)clinical symptoms of anxiety was 38.3% in candidates and 33.7% in recipients. After lung transplantation, 12% of the recipients reported clinical symptoms of PTSD related to the transplantation. Symptoms of anxiety and medication adherence were significantly and positively related in transplant recipients. We found no association between depressive or post-traumatic stress symptoms, and medication adherence.

conclusionsIn lung transplant patients, we found a high prevalence of symptoms of depression and anxiety. Recipients had high levels of post-traumatic stress symptoms related to the transplantation. The prevalence of suicidal ideation was unexpectedly high in recipients. After lung transplantation, higher levels of anxiety were related to better medication adherence. We propose that LTX recipients are very anxious to develop dyspnoea and therefore take their medication more conscientiously. RELEVANCE TO CLINICAL PRACTICE: The clinical nurse specialist can play a key role in identifying and addressing psychological and behavioural problems. More prospective research on the role of anxiety and dyspnoea in lung transplant recipients is recommended.

Indexed as

Lung TransplantationPsychological DistressCross-Sectional StudiesHumansMedication AdherenceProspective Studiesanxietydepressionlung transplantationmedication adherencepost-traumatic stress disordersuicidal ideation

Identifiers

PMID34216066
PMCPMC9292052
OpenAlexW3176475885

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.