BACKGROUND: Nonadherence to immunosuppressant medication is a prevalent practice among kidney transplant recipients and has been associated with increased risk for graft failure and economic burden. The aim of this pilot study was to test whether a culturally sensitive cognitive-behavioral adherence promotion program could significantly improve medication adherence to tacrolimus prescription as measured by telephone pill counts among kidney transplant recipients. METHODS:Thirty-three adult transplant recipients were less than 98% adherent to tacrolimus prescription based on 3 telephone pill counts and were randomized either to the 2-session cognitive-behavioral adherence promotion program or to standard care. The curriculum was developed from an iterative process with transplant recipients into a 2-session group program that provided psychoeducation, addressed barriers to adherence, fostered motivation to improve adherence behavior, and discussed cultural messages on adherence behavior. RESULTS: The intervention group displayed significantly higher levels of adherence when compared to the control group (t = 2.2, p = 0.04) and. similarly, when the amount of change was compared between the groups, the intervention group showed more change than the control condition (F (22,1) = 12.005, p = 0.003). Tacrolimus trough concentration levels were used as a secondary measure of adherence and, while there were no significant between-group differences for mean trough concentration levels, the variability in the trough levels did significantly decrease over time indicating more consistent pill-taking behavior in the intervention group. CONCLUSIONS: There is preliminary support for the pilot program as a successful intervention in helping patients with their immunosuppressant medication.
RCT Entities:
BACKGROUND: Nonadherence to immunosuppressant medication is a prevalent practice among kidney transplant recipients and has been associated with increased risk for graft failure and economic burden. The aim of this pilot study was to test whether a culturally sensitive cognitive-behavioral adherence promotion program could significantly improve medication adherence to tacrolimus prescription as measured by telephone pill counts among kidney transplant recipients. METHODS: Thirty-three adult transplant recipients were less than 98% adherent to tacrolimus prescription based on 3 telephone pill counts and were randomized either to the 2-session cognitive-behavioral adherence promotion program or to standard care. The curriculum was developed from an iterative process with transplant recipients into a 2-session group program that provided psychoeducation, addressed barriers to adherence, fostered motivation to improve adherence behavior, and discussed cultural messages on adherence behavior. RESULTS: The intervention group displayed significantly higher levels of adherence when compared to the control group (t = 2.2, p = 0.04) and. similarly, when the amount of change was compared between the groups, the intervention group showed more change than the control condition (F (22,1) = 12.005, p = 0.003). Tacrolimus trough concentration levels were used as a secondary measure of adherence and, while there were no significant between-group differences for mean trough concentration levels, the variability in the trough levels did significantly decrease over time indicating more consistent pill-taking behavior in the intervention group. CONCLUSIONS: There is preliminary support for the pilot program as a successful intervention in helping patients with their immunosuppressant medication.
Authors: Arthur J Matas; Abhinav Humar; Kristen J Gillingham; William D Payne; Rainer W G Gruessner; Raja Kandaswamy; David L Dunn; John S Najarian; David E R Sutherland Journal: Kidney Int Date: 2002-08 Impact factor: 10.612
Authors: Lisa Mellon; Frank Doyle; Anne Hickey; Kenneth D Ward; Declan G de Freitas; P Aiden McCormick; Oisin O'Connell; Peter Conlon Journal: Cochrane Database Syst Rev Date: 2022-09-12
Authors: Mary Amanda Dew; Donna M Posluszny; Andrea F DiMartini; Larissa Myaskovsky; Jennifer L Steel; Annette J DeVito Dabbs Journal: Curr Transplant Rep Date: 2018-04-17
Authors: Daniela P Ladner; Michael S Wolf; Esther S Yoon; Scott Hur; Laura M Curtis; Aiden H Wynia; Pauline Zheng; Sumi S Nair; Stacy C Bailey; Marina Serper; Peter P Reese Journal: JMIR Form Res Date: 2022-05-05
Authors: Jennifer Felicia Scheel; Katharina Schieber; Sandra Reber; Lisa Stoessel; Elisabeth Waldmann; Sabine Jank; Kai-Uwe Eckardt; Franziska Grundmann; Frank Vitinius; Martina de Zwaan; Anna Bertram; Yesim Erim Journal: Front Psychiatry Date: 2018-02-15 Impact factor: 4.157
Authors: Vanessa L Richards; Christopher K Johnson; Christopher D Blosser; Lena Sibulesky Journal: Ann Transplant Date: 2018-09-18 Impact factor: 1.530