Amélie Hugon1, Matthieu Roustit, Audrey Lehmann, Christel Saint-Raymond, Elisabeth Borrel, Marie-Noëlle Hilleret, Paolo Malvezzi, Pierrick Bedouch, Pascal Pansu, Benoît Allenet. 1. 1 Pharmacy Department, Grenoble University Hospital, Grenoble, France. 2 University Grenoble-Alpes, Grenoble, France. 3 Clinical Research Center, Inserm CIC1406, Grenoble University Hospital, Grenoble, France. 4 TIMC-IMAG UMR 5525/ThEMAS, Grenoble, France. 5 Pneumology Department, Grenoble University Hospital, Grenoble, France. 6 Cardiology Department, Grenoble University Hospital, Grenoble, France. 7 Hepatogastroenterology Department, Grenoble University Hospital, Grenoble, France. 8 Nephrology Department, Grenoble University Hospital, Grenoble, France. 9 Laboratory of Educational Sciences, Grenoble, France. 10 Address correspondence to: Benoît Allenet, Pharm.D., Pôle Pharmacie, CHU de Grenoble, 38043 Grenoble Cedex 09, France.
Abstract
INTRODUCTION: Nonadherence to immunosuppressive (IS) therapy is associated with poor outcomes. Identifying factors predicting poor adherence is therefore essential. The primary objective of this study was to test whether parameters of a model adapted from the theory of planned behavior, and more specifically attitudes that are influenced by beliefs and satisfaction with medication, could predict adherence in solid organ transplant patients. METHODS: Adherence was assessed with a self-reported medication adherence scale and IS blood trough concentrations over 6 months, in four transplant units. Satisfaction and beliefs were assessed using the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) and Beliefs about Medicines Questionnaire (BMQ), respectively. Theory of planned behavior was assessed with a specific questionnaire exploring intentions, subjective norms, attitudes and perceived behavioral control. Treatment characteristics and socioeconomic data were also collected. RESULTS: One hundred and fifty-three solid organ transplant patients were enrolled, including lung (n=33), heart (n=43), liver (n=42), and kidney (n=44) patients. Satisfaction and positive beliefs about medication were higher in adherent than those in nonadherent patients. Factors independently associated with an increased risk of nonadherence were negative general beliefs about medications (odds ratio [OR]=0.89 [0.83-0.97]), living alone (OR=2.78 [1.09-7.09]), heart transplantation (OR=3.49 [1.34-9.09]), and being on everolimus (OR=5.02 [1.21-20.8]). CONCLUSION: Negative beliefs toward medications were shown to be an independent risk factor of poor adherence. Therefore, the BMQ could be an effective, easy to implement tool, for use in everyday practice, to identify patients needing interventions to improve adherence to IS.
INTRODUCTION: Nonadherence to immunosuppressive (IS) therapy is associated with poor outcomes. Identifying factors predicting poor adherence is therefore essential. The primary objective of this study was to test whether parameters of a model adapted from the theory of planned behavior, and more specifically attitudes that are influenced by beliefs and satisfaction with medication, could predict adherence in solid organ transplant patients. METHODS: Adherence was assessed with a self-reported medication adherence scale and IS blood trough concentrations over 6 months, in four transplant units. Satisfaction and beliefs were assessed using the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) and Beliefs about Medicines Questionnaire (BMQ), respectively. Theory of planned behavior was assessed with a specific questionnaire exploring intentions, subjective norms, attitudes and perceived behavioral control. Treatment characteristics and socioeconomic data were also collected. RESULTS: One hundred and fifty-three solid organ transplant patients were enrolled, including lung (n=33), heart (n=43), liver (n=42), and kidney (n=44) patients. Satisfaction and positive beliefs about medication were higher in adherent than those in nonadherent patients. Factors independently associated with an increased risk of nonadherence were negative general beliefs about medications (odds ratio [OR]=0.89 [0.83-0.97]), living alone (OR=2.78 [1.09-7.09]), heart transplantation (OR=3.49 [1.34-9.09]), and being on everolimus (OR=5.02 [1.21-20.8]). CONCLUSION: Negative beliefs toward medications were shown to be an independent risk factor of poor adherence. Therefore, the BMQ could be an effective, easy to implement tool, for use in everyday practice, to identify patients needing interventions to improve adherence to IS.
Authors: J Lehrer; E Brissot; A Ruggeri; R Dulery; A Vekhoff; G Battipaglia; F Giannotti; C Fernandez; M Mohty; M Antignac Journal: Bone Marrow Transplant Date: 2017-11-20 Impact factor: 5.483
Authors: Katrin Birkefeld; Maximilian Bauer-Hohmann; Felix Klewitz; Eva-Marie Kyaw Tha Tun; Uwe Tegtbur; Lars Pape; Lena Schiffer; Mario Schiffer; Martina de Zwaan; Mariel Nöhre Journal: J Clin Psychol Med Settings Date: 2022-02-23
Authors: Tasmeen Hussain; Keira Nassetta; Linda C O'Dwyer; Jane E Wilcox; Sherif M Badawy Journal: Transplant Rev (Orlando) Date: 2021-09-20 Impact factor: 3.943
Authors: Sharad I Wadhwani; John C Bucuvalas; Cole Brokamp; Ravinder Anand; Ashutosh Gupta; Stuart Taylor; Eyal Shemesh; Andrew F Beck Journal: Transplantation Date: 2020-11 Impact factor: 5.385