Remon Helmy1, Samira Scalso de Almeida2, Kris Denhaerynck1, Lut Berben3, Fabienne Dobbels4, Cynthia L Russell5, Bartira de Aguiar Roza6, Sabina De Geest7. 1. Institute of Nursing Science, Department Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland. 2. Hospital Municipal Vila Santa Catarina - Ministério da Saúde PROADI-SUS, São Paulo, Brazil; School of Nursing, Federal University of São Paulo, São Paolo, Brazil. 3. Institute of Nursing Science, Department Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland; University Hospital Basel, Basel, Switzerland. 4. Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium. 5. School of Nursing and Health Studies, University of Missouri, Kansas City, MO, USA. 6. School of Nursing, Federal University of São Paulo, São Paolo, Brazil. 7. Institute of Nursing Science, Department Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland; Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium. Electronic address: sabina.degeest@unibas.ch.
Abstract
PURPOSE: To assess and compare the prevalence of medication nonadherence (MNA) (implementation and persistence) to immunosuppressants and co-medications in heart transplant recipients. METHODS: MNA prevalence was assessed using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (self-report) and compared using logistic regression in a 4-continent sample of 1397 heart transplant recipients from 36 heart transplant centers in 11 countries. FINDINGS: MNA was significantly (α = 0.05) higher to co-medications than to immunosuppressants (taking nonadherence: 23.9% vs 17.3%; odds ratio [OR] = 1.5; 95% CI, 1.30-1.73; drug holiday: 5.7% vs 1.9%; OR = 3.17; 95% CI, 2.13-4.73; dose alteration: 3.8% vs 1.6%; OR = 2.46; 95% CI, 1.49-4.06; and discontinuation: 2.6% vs 0.5%; OR = 5.15; 95% CI, 2.36-11.20). IMPLICATIONS: The observed MNA necessitates adherence-enhancing interventions encompassing the entire post-heart transplant medication regimen. ClinicalTrials.gov identifier: NCT01608477.
PURPOSE: To assess and compare the prevalence of medication nonadherence (MNA) (implementation and persistence) to immunosuppressants and co-medications in heart transplant recipients. METHODS: MNA prevalence was assessed using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (self-report) and compared using logistic regression in a 4-continent sample of 1397 heart transplant recipients from 36 heart transplant centers in 11 countries. FINDINGS: MNA was significantly (α = 0.05) higher to co-medications than to immunosuppressants (taking nonadherence: 23.9% vs 17.3%; odds ratio [OR] = 1.5; 95% CI, 1.30-1.73; drug holiday: 5.7% vs 1.9%; OR = 3.17; 95% CI, 2.13-4.73; dose alteration: 3.8% vs 1.6%; OR = 2.46; 95% CI, 1.49-4.06; and discontinuation: 2.6% vs 0.5%; OR = 5.15; 95% CI, 2.36-11.20). IMPLICATIONS: The observed MNA necessitates adherence-enhancing interventions encompassing the entire post-heart transplant medication regimen. ClinicalTrials.gov identifier: NCT01608477.
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