STUDY OBJECTIVE: To determine the influence of pill burden and drug cost on outcomes after renal transplantation. DESIGN: Retrospective medical record review. SETTING: Kidney and pancreas transplantation center. PATIENTS: Sixty-eight adults who underwent kidney or kidney-pancreas transplantation during 2007. MEASUREMENTS AND MAIN RESULTS: The median pretransplantation pill burden was 15 pills/day, which increased to 25 pills/day at 1 month after transplantation and returned to 16 pills/day by 1 year after transplantation. Pretransplantation pill burden was lower than the burden at 1, 3, 6, 12, and 24 months after transplantation (p<0.05). The mean pretransplantation drug cost of $1918/month was lower than the cost at 1 month after transplantation ($2564/mo, p=0.04) but was similar thereafter. Higher pretransplantation pill burden was associated with increased serum creatinine concentration at 6 months after transplantation (r=0.288, p=0.017). Higher pill burdens at 1 month (r=0.364, p=0.002), 3 months (r=0.332, p=0.006), and 6 months (r=0.374, p=0.002) were associated with increased 3-month serum creatinine concentration. Higher drug costs were associated with increased serum creatinine concentrations throughout the study. CONCLUSION: Higher pretransplantation pill burden and higher drug cost may be associated with poor renal function after transplantation. Further study addressing factors associated with nonadherence is needed.
STUDY OBJECTIVE: To determine the influence of pill burden and drug cost on outcomes after renal transplantation. DESIGN: Retrospective medical record review. SETTING: Kidney and pancreas transplantation center. PATIENTS: Sixty-eight adults who underwent kidney or kidney-pancreas transplantation during 2007. MEASUREMENTS AND MAIN RESULTS: The median pretransplantation pill burden was 15 pills/day, which increased to 25 pills/day at 1 month after transplantation and returned to 16 pills/day by 1 year after transplantation. Pretransplantation pill burden was lower than the burden at 1, 3, 6, 12, and 24 months after transplantation (p<0.05). The mean pretransplantation drug cost of $1918/month was lower than the cost at 1 month after transplantation ($2564/mo, p=0.04) but was similar thereafter. Higher pretransplantation pill burden was associated with increased serum creatinine concentration at 6 months after transplantation (r=0.288, p=0.017). Higher pill burdens at 1 month (r=0.364, p=0.002), 3 months (r=0.332, p=0.006), and 6 months (r=0.374, p=0.002) were associated with increased 3-month serum creatinine concentration. Higher drug costs were associated with increased serum creatinine concentrations throughout the study. CONCLUSION: Higher pretransplantation pill burden and higher drug cost may be associated with poor renal function after transplantation. Further study addressing factors associated with nonadherence is needed.
Authors: Tom D Blydt-Hansen; Christopher B Pierce; Yi Cai; Dmitri Samsonov; Susan Massengill; Marva Moxey-Mims; Bradley A Warady; Susan L Furth Journal: Clin J Am Soc Nephrol Date: 2013-11-21 Impact factor: 8.237
Authors: Amy D Waterman; Anna-Michelle M McSorley; John D Peipert; Christina J Goalby; Leanne J Peace; Patricia A Lutz; Jessica L Thein Journal: BMC Nephrol Date: 2015-08-28 Impact factor: 2.388
Authors: Christina A Spivey; Marie A Chisholm-Burns; Charlene Garrett; Kenneth M Duke Journal: Patient Prefer Adherence Date: 2014-05-02 Impact factor: 2.711