BACKGROUND: Although adherence to immunosupressive medication after transplantation is important to maximize good clinical outcomes it remains suboptimal and not well-understood. The purpose of this study was to examine intentional and unintentional non-adherence to immunosuppression medication in kidney transplant patients. METHODS: A cross-sectional sample of N=218 patients [49.6 ± 12.3 years] recruited in London, UK (1999-2002) completed measures of medication beliefs, quality-of-life, depression, and transplantation-specific emotions. Adherence was measured with self-report and serial immunosuppressive assays. RESULTS: Intentional non-adherence was low (13.8 %) yet 62.4 % admitted unintentional non-adherence and 25.4 % had sub-target immunosuppressive levels. The risk of sub-target serum immunosuppressive levels was greater for patients admitting unintentional non-adherence (OR=8.4; p=0.004). Dialysis vintage, doubts about necessity, and lower worry about viability of graft explained R(2)=16.1 to 36 % of self-report non-adherence. Depression was related only to intentional non-adherence. CONCLUSIONS: Non-adherence is common in kidney transplantation. Efforts to increase adherence should be implemented by targeting necessity beliefs, monitoring depression, and promoting strategies to decrease forgetfulness.
BACKGROUND: Although adherence to immunosupressive medication after transplantation is important to maximize good clinical outcomes it remains suboptimal and not well-understood. The purpose of this study was to examine intentional and unintentional non-adherence to immunosuppression medication in kidney transplant patients. METHODS: A cross-sectional sample of N=218 patients [49.6 ± 12.3 years] recruited in London, UK (1999-2002) completed measures of medication beliefs, quality-of-life, depression, and transplantation-specific emotions. Adherence was measured with self-report and serial immunosuppressive assays. RESULTS: Intentional non-adherence was low (13.8 %) yet 62.4 % admitted unintentional non-adherence and 25.4 % had sub-target immunosuppressive levels. The risk of sub-target serum immunosuppressive levels was greater for patients admitting unintentional non-adherence (OR=8.4; p=0.004). Dialysis vintage, doubts about necessity, and lower worry about viability of graft explained R(2)=16.1 to 36 % of self-report non-adherence. Depression was related only to intentional non-adherence. CONCLUSIONS: Non-adherence is common in kidney transplantation. Efforts to increase adherence should be implemented by targeting necessity beliefs, monitoring depression, and promoting strategies to decrease forgetfulness.
Authors: Mary Amanda Dew; Emily M Rosenberger; Larissa Myaskovsky; Andrea F DiMartini; Annette J DeVito Dabbs; Donna M Posluszny; Jennifer Steel; Galen E Switzer; Diana A Shellmer; Joel B Greenhouse Journal: Transplantation Date: 2015-05 Impact factor: 4.939
Authors: Rachel E Patzer; Marina Serper; Peter P Reese; Kamila Przytula; Rachel Koval; Daniela P Ladner; Josh M Levitsky; Michael M Abecassis; Michael S Wolf Journal: Clin Transplant Date: 2016-08-29 Impact factor: 2.863
Authors: Emily M Geramita; Annette J DeVito Dabbs; Andrea F DiMartini; Joseph M Pilewski; Galen E Switzer; Donna M Posluszny; Larissa Myaskovsky; Mary Amanda Dew Journal: Transplantation Date: 2020-03 Impact factor: 5.385