Transplant International (Mar 2024)

Trust in the Transplant Team Associated With the Level of Chronic Illness Management—A Secondary Data Analysis of the International BRIGHT Study

  • Juliane Mielke,
  • Maan Isabella Cajita,
  • Kris Denhaerynck,
  • Sabine Valenta,
  • Sabine Valenta,
  • Fabienne Dobbels,
  • Cynthia L. Russell,
  • Sabina De Geest,
  • Sabina De Geest,
  • the BRIGHT study team,
  • Luis Almenar-Bonet,
  • Andrea Cotait Ayoub,
  • Fernanda Barone,
  • Lut Berben,
  • Andrée Bernard,
  • Vicens Brossa-Loidi,
  • Karyn Ryan Canales,
  • Katherine St. Clair,
  • Johan Van Cleemput,
  • Bernice Coleman,
  • Marisa G. Crespo-Leiro,
  • Sandra Cupples,
  • Patricia M. Davidson,
  • Bartira De Aguiar Roza,
  • Samira Scalso De Almeida,
  • Paolo De Simone,
  • Andreas Doesch,
  • Flavio R. Epstein,
  • Ashi Firouzi,
  • Grant Fisher,
  • Maureen Flattery,
  • Albert Groenewoud,
  • Haissam Haddad,
  • Michelle Harkess,
  • Eva Horvath,
  • Alain Jean Poncelet,
  • Annemarie Kaan,
  • Andrew Kao,
  • Stella Kozuszko,
  • Christiane Kugler,
  • Ugolino Livi,
  • Kristin Ludrosky,
  • Joanne Maddicks-Law,
  • Magali Michel,
  • Tara Miller,
  • Paul Mohacsi,
  • Maria Molina,
  • Linda Ohler,
  • Gareth Parry,
  • Luciano Potenta,
  • Cheryl Riotto,
  • Carmen Segura Saint-Gerons,
  • Laurent Sebbag,
  • Javier Segovia-Cubero,
  • Jacqueline Trammell

DOI
https://doi.org/10.3389/ti.2024.11704
Journal volume & issue
Vol. 37

Abstract

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A trustful relationship between transplant patients and their transplant team (interpersonal trust) is essential in order to achieve positive health outcomes and behaviors. We aimed to 1) explore variability of trust in transplant teams; 2) explore the association between the level of chronic illness management and trust; 3) investigate the relationship of trust on behavioral outcomes. A secondary data analysis of the BRIGHT study (ID: NCT01608477; https://clinicaltrials.gov/ct2/show/NCT01608477?id=NCT01608477&rank=1) was conducted, including multicenter data from 36 heart transplant centers from 11 countries across four different continents. A total of 1,397 heart transplant recipients and 100 clinicians were enrolled. Trust significantly varied among the transplant centers. Higher levels of chronic illness management were significantly associated with greater trust in the transplant team (patients: AOR= 1.85, 95% CI = 1.47–2.33, p < 0.001; clinicians: AOR = 1.35, 95% CI = 1.07–1.71, p = 0.012). Consultation time significantly moderated the relationship between chronic illness management levels and trust only when clinicians spent ≥30 min with patients. Trust was significantly associated with better diet adherence (OR = 1.34, 95%CI = 1.01–1.77, p = 0.040). Findings indicate the relevance of trust and chronic illness management in the transplant ecosystem to achieve improved transplant outcomes. Thus, further investment in re-engineering of transplant follow-up toward chronic illness management, and sufficient time for consultations is required.

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