Early in her career as a nurse on an organ transplant team, Cynthia Russell, Ph.D., recognized a lack of information and resources to help patients take their medications. Twenty years later, that passion for medication adherence is a driving force in Russell’s research career.
Today, she is a professor at the UMKC School of Nursing and Health Studies. In her early days on the transplant team, she noticed a pattern in her patients. According to Russell, patients receiving a kidney or heart transplant – long and expensive procedures – need to take medications for the life of the organ so the body doesn’t reject it. Because the body sees the organ as a foreign object, transplant recipients need immunosuppressive medications to keep their immune systems subdued. If a patient skips the medications, the body will attack the new organ.
“That was the trigger for me in going into research and getting my Ph.D.,” said Russell. “My patients really struggled with taking the medications, and when we looked at the evidence available at the time, we couldn’t really find good ways to help them keep up with taking them.”
Russell’s research in this area has been continuously funded since 2002. That includes a $2.5 million grant from the National Institute of Health to study intervention techniques that help kidney transplant patients take their medications successfully.
Russell recently expanded her research to other wellness areas as well. In her role as a fellow at the American Academy of Nursing, she worked on a committee tasked with improving healthy behaviors in patients and their health care providers. The committee conducted a survey of critical care nurses studying their overall physical and mental health – a key issue in health care professions today. The findings were published this spring and have received national notice, including NPR’s Weekend Edition.
In Russell’s research with kidney transplant patients, her team utilized the SystemCHANGE intervention. The approach moves away from traditional interventions that focus on motivation and intention. Instead, SystemCHANGE improves the patient’s ability to monitor small environmental changes and determine the effectiveness of the changes using data. According to Russell, about 75 percent of the patient population being studied struggles to take their medicines as directed.
“It continues to be a critical issue nationwide,” she said.
According to the Health Resources and Services Administration, there are 106,691 people on the national transplant waiting list, increasing the importance that each procedure is given the best chance at success. And that includes patients taking the needed medications.
“That organ is something that we want to try to take care of so it lasts a long time,” said Russell. “A successful transplant means other patients will have their chance at organ donation since the recipient won’t need to return for a second or third procedure.”