Medication Adherence in Patients Taking Immunosuppressants after Kidney Transplantation

Results: Among 197 patients, 113 (57.4%) were compliant to the immunosuppressive agents, and 84 (42.6%) recipients were non-compliant. Non-compliant patients were significantly younger (P=0.004), highly educated (P=0.004), employed (P=0.005), more likely to live alone (P=0.035), and drank more (P=0.001) than the compliant patients. Regarding psychosocial factors, more barriers (P=0.015), weak beliefs about the necessity of taking medications (P=0.001), strong beliefs about specific concerns related to medications (P=0.038), and low self efficacy (P=0.003) were identified in the non-compliant group compared with the compliant group. Conclusions: This study revealed that multiple factors affected medication compliance in patients taking immunosuppressants. It would be helpful to identify potential recipients with a risk for non-compliance based on their general characteristics and psychosocial factors, so they can be provided a specialized education program to promote compliance. This strategy may help produce more favorable long-term outcomes among kidney transplant recipients.

[1]  E. Mohammadi,et al.  Barriers and facilitators related to the implementation of a physiological track and trigger system: A systematic review of the qualitative evidence , 2017, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[2]  P. Kimmel,et al.  Depression is an important contributor to low medication adherence in hemodialyzed patients and transplant recipients. , 2009, Kidney international.

[3]  E. Gordon,et al.  Medication‐taking among adult renal transplant recipients: barriers and strategies , 2009, Transplant international : official journal of the European Society for Organ Transplantation.

[4]  S. Huprikar.  Solid Organ Transplantation in HIV Patients , 2008 .

[5]  L. Matza,et al.  Further testing of the reliability and validity of the ASK-20 adherence barrier questionnaire in a medical center outpatient population* , 2008, Current medical research and opinion.

[6]  S. Hahn,et al.  Development of the ASK-20 Adherence Barrier Survey* , 2008 .

[7]  N. Ichimaru,et al.  Treatment adherence in renal transplant recipients: a questionnaire survey on immunosuppressants. , 2008, Transplantation proceedings.

[8]  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.

[9]  M. Schnitzler,et al.  A Retrospective Analysis of Immunosuppression Compliance, Dose Reduction and Discontinuation in Kidney Transplant Recipients , 2007, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[10]  G. Cappelli,et al.  Psychological factors associated with medication adherence following renal transplantation , 2007, Clinical transplantation.

[11]  S. Willis,et al.  Patient perceptions of factors influencing adherence to medication following kidney transplant , 2007, Psychology, health & medicine.

[12]  F. Murphy.  The role of the nurse post-renal transplantation. , 2007, British journal of nursing.

[13]  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.

[14]  Joseph Thomas,et al.  Relationships Between Beliefs about Medications and Nonadherence to Prescribed Chronic Medications , 2006, The Annals of pharmacotherapy.

[15]  M. Hébert,et al.  Impact of stress, distress and feelings of indebtedness on adherence to immunosuppressants following kidney transplantation , 2006, Clinical transplantation.

[16]  C. Lance,et al.  Development and validation of the immunosuppressant therapy adherence instrument (ITAS). , 2005, Patient education and counseling.

[17]  F. Dobbels,et al.  Prevalence, consequences, and determinants of nonadherence in adult renal transplant patients: a literature review , 2005, Transplant international : official journal of the European Society for Organ Transplantation.

[18]  J. Vlasnik,et al.  Medication adherence: factors influencing compliance with prescribed medication plans. , 2005, The Case manager.

[19]  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.

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

[21]  R. Jindal,et al.  Noncompliance after solid organ transplantation. , 2001, Transplantation.

[22]  A. Pruna,et al.  European multicenter survey on noncompliance after solid organ transplantation. , 2000, Transplantation proceedings.

[23]  S. De Geest,et al.  Symptom experience associated with maintenance immunosuppression after heart transplantation: patients' appraisal of side effects. , 1998, Heart & lung : the journal of critical care.

[24]  S. Geest,et al.  Development of the long-term medication behaviour self-efficacy scale: qualitative study for item development. , 1994, Journal of advanced nursing.

[25]  Mary Anne Koda-Kimble,et al.  Applied Therapeutics: The Clinical Use of Drugs , 1992 .

[26]  A. Matas,et al.  Overview of noncompliance in renal transplantation , 1991 .

[27]  K. Yoo,et al.  The center for epidemiologic studies-depression scale: its use in Korea , 1991 .

[28]  D. Dunn,et al.  Solid organ transplantation. Where has it been, where is it going? , 1990, Critical care clinics.

[29]  S. Bartuś,et al.  Noncompliance in organ transplant recipients. , 1990, Transplantation.

[30]  J. Weinman,et al.  The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication , 1999 .

[31]  P. Frazier,et al.  Correlates of noncompliance among renal transplant recipients. , 1994, Clinical transplantation.

[32]  N. Kutner,et al.  Quality of life of patients with end-stage renal disease. , 1985, The New England journal of medicine.