Adherence to and Acceptance of Once-Daily Tacrolimus After Kidney and Liver Transplant: Results From OSIRIS, a French Observational Study

Background Adherence to immunosuppressive treatments is a major concern in transplanted patients. Methods This 6-month French observational, longitudinal, prospective study aimed to assess patient adherence to and acceptance of once-daily tacrolimus (Advagraf) initiation in kidney and liver transplant recipients. Data from 1106 patients initiating once-daily tacrolimus during posttransplant follow-up were analyzed. Adherence and acceptance were assessed using self-administered questionnaires at inclusion and at 3 and 6 months. Results Mean age was 52.4 ± 13.2 years, 61.5% were men. For 94.9% of patients, once-daily tacrolimus was prescribed after switching from twice-daily tacrolimus. At inclusion, 20.9% of patients reported good treatment adherence, 72.0% minor nonadherence, and 7.1% were nonadherent. Mean general acceptance score (range, 0-100) was 77.7 (±24.7). At 3 months, adherence was improved in 21.1%, unchanged in 69.2%, and worsened in 9.7% of patients. Mean general acceptance score was 75.4 (±26.5). General acceptance score was improved in 28.0%, unchanged in 39.4%, and worsened in 32.7% of patients. At 6 months, similar changes in adherence and acceptance were observed. Higher general acceptance score at month 3 was significantly associated with better adherence at month 6. Conclusions Conversion to once-daily tacrolimus led to an improved rate of adherence at month 3 in more than 20% of patients and a worsened rate of adherence in less than 10% of patients.

[1]  A. Regnault,et al.  Validation of Accept, a New Generic Measure to Assess How Patients with Chronic Diseases Balance Between the Advantages and Disadvantages of Following the Recommended Treatment Regimen in Real-life , 2013 .

[2]  D. Misdrahi,et al.  Factors Predictive of Medication Nonadherence After Renal Transplantation: A French Observational Study , 2013, Transplantation.

[3]  D. Patrick,et al.  Long-Term Treatment Acceptance , 2012, The Patient: Patient-Centered Outcomes Research.

[4]  D. Patrick,et al.  Long-term treatment acceptance: what is it, and how can it be assessed? , 2012, The patient.

[5]  B. Koneru,et al.  Self‐reported non‐adherence to immune‐suppressant therapy in liver transplant recipients: demographic, interpersonal, and intrapersonal factors , 2012, Clinical transplantation.

[6]  B. Krämer,et al.  Tacrolimus Once Daily (ADVAGRAF) Versus Twice Daily (PROGRAF) in De Novo Renal Transplantation: A Randomized Phase III Study , 2010, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[7]  A. Watson,et al.  Multidisciplinary Insights Into Optimizing Adherence After Solid Organ Transplantation , 2010, Transplantation.

[8]  J. Amar,et al.  Six-item self-administered questionnaires in the waiting room: an aid to explain uncontrolled hypertension in high-risk patients seen in general practice. , 2009, Journal of the American Society of Hypertension : JASH.

[9]  F. Dobbels,et al.  Nonadherence Consensus Conference Summary Report , 2008, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[10]  J. Steiger,et al.  Diagnostic Accuracy of Measurement Methods to Assess Non‐Adherence to Immunosuppressive Drugs in Kidney Transplant Recipients , 2008, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[11]  R. Hansen,et al.  Medication adherence in chronic disease: issues in posttransplant immunosuppression. , 2007, Transplantation proceedings.

[12]  J. Greenhouse,et al.  Rates and Risk Factors for Nonadherence to the Medical Regimen After Adult Solid Organ Transplantation , 2007, Transplantation.

[13]  P. Kuo,et al.  One‐Year Results with Extended‐Release Tacrolimus/MMF, Tacrolimus/MMF and Cyclosporine/MMF in De Novo Kidney Transplant Recipients , 2007, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[14]  K. Denhaerynck,et al.  Prevalence and Risk Factors of Non‐Adherence with Immunosuppressive Medication in Kidney Transplant Patients , 2007, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[15]  J. Trotter,et al.  Immunosuppression: Evolution in Practice and Trends, 1994–2004 , 2006, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[16]  M. Chisholm,et al.  Modified-Release Tacrolimus , 2006, The Annals of pharmacotherapy.

[17]  A. Lippman.  Adherence to medication. , 2005, The New England journal of medicine.

[18]  A. Israni,et al.  Race and electronically measured adherence to immunosuppressive medications after deceased donor renal transplantation. , 2005, Journal of the American Society of Nephrology : JASN.

[19]  A. Monaco,et al.  Factors contributing to acute rejection in renal transplantation: the role of noncompliance. , 2005, Transplantation proceedings.

[20]  Evelyne Lerut,et al.  Prospective Study on Late Consequences of Subclinical Non‐Compliance with Immunosuppressive Therapy in Renal Transplant Patients , 2004, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[21]  R. Alloway.  CONVERSION OF STABLE KIDNEY TRANSPLANT RECIPIENTS FROM A TWICE DAILY PROGRAF BASED REGIMEN TO A ONCE DAILY MODIFIED RELEASE TACROLIMUS BASED REGIMEN , 2004, Transplantation proceedings.

[22]  P. Roderick,et al.  Frequency and impact of nonadherence to immunosuppressants after renal transplantation: a systematic review , 2004, Transplantation.

[23]  P. Roderick,et al.  Measuring compliance with drug regimens after renal transplantation: comparison of self-report and clinician rating with electronic monitoring , 2004, Transplantation.

[24]  S. Crawford,et al.  Pharmaceutical services in rural hospitals in Illinois--2001. , 2003, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[25]  E. Benedetti,et al.  Medication noncompliance after kidney transplantation. , 2003, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[26]  T. Michelon,et al.  Noncompliance as a cause of renal graft loss. , 2002, Transplantation proceedings.

[27]  R. Jindal,et al.  Compliance and late acute rejection after kidney transplantation: a psycho‐medical perspective , 2002, Clinical transplantation.

[28]  O. Hanon,et al.  Evaluation de l'observance du traitement antihypertenseur par un questionnaire : mise au point et utilisation dans un service spécialisé , 2001 .

[29]  L. Shaw,et al.  Clinical Utility of Monitoring Tacrolimus Blood Concentrations in Liver Transplant Patients , 2001, Journal of clinical pharmacology.

[30]  B Bunzel,et al.  Noncompliance in organ transplant recipients: a literature review. , 2000, General hospital psychiatry.

[31]  J. Dipiro,et al.  RENAL TRANSPLANT PATIENT COMPLIANCE WITH FREE IMMUNOSUPPRESSIVE MEDICATIONS1 , 2000, Transplantation.

[32]  M. Henry,et al.  Medication compliance following renal transplantation. , 1998, Transplantation.

[33]  T. Starzl,et al.  Clinical Pharmacokinetics of Tacrolimus , 1995, Clinical pharmacokinetics.

[34]  T. Starzl,et al.  FK 506 FOR LIVER, KIDNEY, AND PANCREAS TRANSPLANTATION , 1989, The Lancet.

[35]  P. Burkhart,et al.  Adherence to long-term therapies: evidence for action. , 2003, Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing.

[36]  O. Hanon,et al.  [Assessment of antihypertensive compliance using a self-administered questionnaire: development and use in a hypertension clinic]. , 2001, Presse medicale.

[37]  Linda Sher,et al.  A comparison of tacrolimus (FK 506) and cyclosporine for immunosuppression in liver transplantation. , 1994, The New England journal of medicine.

[38]  P. Kandela.  South Africa: medical care of detainees. , 1985, Lancet.