Prevalence and correlates of medication non-adherence among kidney transplant recipients more than 6 months post-transplant: a cross-sectional study

BMC Nephrology

Kitaw Demissie³  Marie A Chisholm-Burns¹  Christopher Zacker²  Karen M Kurtyka³  Sheenu Chandwani³  Francis L Weng³ 

[1] University of Tennessee Health Science Center, College of Pharmacy, 881 Madison Ave, Suite 264, Memphis, Tennessee 38163, USA;Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, New Jersey 07936, USA;Department of Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, New Jersey 08854, USA

关键词: Adherence;    Compliance;    Epidemiology;    Kidney transplantation;   

Others  :  1082778
DOI  :  10.1186/1471-2369-14-261

 received in 2013-03-07, accepted in 2013-11-25,  发布年份 2013

【 摘 要 】

Background

Among kidney transplant recipients, non-adherence with immunosuppressive medications frequently precedes allograft loss. We sought to determine the prevalence and correlates of medication non-adherence among kidney transplant recipients.

Methods

We performed a single-center, cross-sectional study of kidney transplant recipients who were at least 6 months post-transplant. We measured self-reported adherence using the Immunosuppressive Therapy Adherence Scale (ITAS, which is scored from 0 to 12, where higher scores indicate increased adherence) and barriers to adherence using the Immunosuppressive Therapy Barriers Scale (ITBS). We also used validated scales to measure perceived stress, health literacy, anxiety, depression, and interpersonal support.

Results

The 252 patients included in the study were 59.9% male, 27.0% Black, and at a median of 2.9 years post-transplant (interquartile range [IQR] 1.4-5.8). On the ITAS, 59.1% scored a perfect 12, 26.6% scored 10–11, and 14.3% scored 0–9. In univariate models, non-adherence (defined as ITAS score ≤9) was significantly associated with increased scores on scales for perceived stress (OR 1.12, 95% CI 1.01-1.25) and depression (OR 1.14, 95% CI 1.02-1.28), and with more self-reported barriers to adherence on the ITBS (OR 1.15, 95% CI 1.08-1.22). After adjusting for sociodemographic factors, stress and depression were not associated with non-adherence. Higher scores on the ITBS (corresponding to more self-described barriers to adherence) were associated with lower scores on the ITAS (P < 0.001). Several individual barriers were associated with non-adherence.

Conclusions

Among prevalent kidney transplant recipients, a minority is non-adherent. Practical barriers to adherence may serve as promising targets for future interventions.

【 授权许可】

   
2013 Weng et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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