Adherence in patients in the first year after kidney transplantation and its impact on graft loss and mortality: a cross‐sectional and prospective study

Prihodová, Lucia; Nagyová, Iveta; Rosenberger, Jaroslav; Majerníková, Mária; Roland, Róbert; Groothoff, Johan W.; Dijk, Jitse P. van

doi:10.1111/jan.12447

Cited by 73 publications

(70 citation statements)

References 49 publications

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“…[17] The results showed that most patients had good adherence to taking medication and various studies have confirmed these findings. [4131518] Patients adherence in this study was higher than that reported in the study by Shabany Hamedan et al .,[19] which might be due to increased awareness of the patients regarding the importance of taking certain medications. Patients' adherence was affected by various factors.…”

Section: Discussioncontrasting

confidence: 63%

“…Patients who used medication observed better performance of the transplanted organ, and despite experiencing side effects, they still used the medications. [18] Therefore, educating the patients about the side effects as well as the importance of using drugs, despite the complications that are not life-threatening, is necessary. The results of the present study indicated that the patients who were greatly supported by their family compared to other patients had good adherence to using medications, which is in agreement with other studies.…”

Section: Discussionmentioning

confidence: 99%

“…The results of the present study indicated that the patients who were greatly supported by their family compared to other patients had good adherence to using medications, which is in agreement with other studies. [1018] Family support could provide benefits for the patients which friends' support could not. [12] Another finding of this study was that low level of education was associated with reduced medication compliance, which was similar to the findings of Prihodova et al .…”

Section: Discussionmentioning

confidence: 99%

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Nonadherence behaviors and some related factors in kidney transplant recipients

Hedayati

Shahgholian

Ghadami

2017

Iranian J Nursing Midwifery Res

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Background:Kidney transplantation is the renal replacement therapy of choice for most patients with end-stage renal disease (ESRD), however, adherence to the recommended lifestyle is critical for a positive prognosis. The purpose of this study was to assess adherence to immunosuppressive therapy and lifestyle recommendations along with some related factors among kidney transplant patients.Materials and Methods:In this descriptive analytical study, all patients completed a questionnaire regarding medication intake and lifestyle recommendations (preventing of infection, self-monitoring, prevention of cardiovascular disease (CVD), and sun protection). The participants were divided into 4 groups according to the level of adherence (good, partial, poor, and nonadherent) indicated in their responses.Results:Most kidney recipients were adherent to their drug prescriptions, but were partial, poor, or nonadherent regarding lifestyle recommendations. Increased passage of time since transplantation and low family support and educational level resulted in nonadherence. Men showed greater adherence to medication intake than women. Patients with lower number of drugs and reported drug side-effects illustrated better adherence to medication intake. Women adhered to infection protection recommendations more than men, and older and married patients adhered to cardiovascular prevention recommendations more than others. However, younger patients showed greater adherence to self-monitoring recommendations, and singles, young individuals, and women were adherent to sun protection recommendations.Conclusions:Nonadherence is common among kidney transplant recipients. Thus, it is necessary to determine patients who are at risk of nonadherence and to introduce more educational programs to improve their adherence and their quality of life (QOL).

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Section: Discussioncontrasting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Nonadherence behaviors and some related factors in kidney transplant recipients

Hedayati

Shahgholian

Ghadami

2017

Iranian J Nursing Midwifery Res

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“…Eventhough there is the risk of social desirability with patient-reported non-adherence assessment (as it is with all self-report variables), patient-reported non-adherence has been shown to be associated with rejection [1, 10–12] and graft loss [1, 2, 6, 11, 13]. However, some studies failed to prove this association [6, 14].…”

Section: Introductionmentioning

confidence: 99%

Patient-reported non-adherence and immunosuppressant trough levels are associated with rejection after renal transplantation

et al. 2017

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BackgroundDifferent measures of non-adherence to immunosuppressant (IS) medication have been found to be associated with rejection episodes after successful transplantation. The aim of the current study was to investigate whether graft rejection after renal transplantation is associated with patient-reported IS medication non-adherence and IS trough level variables (IS trough level variability and percentage of sub-therapeutic IS trough levels).MethodsPatient-reported non-adherence, IS trough level variability, percentage of sub-therapeutic IS trough levels, and acute biopsy-proven late allograft rejections were assessed in 267 adult renal transplant recipients who were ≥12 months post-transplantation.ResultsThe rate of rejection was 13.5%. IS trough level variability, percentage of sub-therapeutic IS trough levels as well as patient-reported non-adherence were all significantly and positively associated with rejection, but not with each other. Logistic regression analyses revealed that only the percentage of sub-therapeutic IS trough levels and age at transplantation remained significantly associated with rejection.ConclusionsParticularly, the percentage of sub-therapeutic IS trough levels is associated with acute rejections after kidney transplantation whereas IS trough level variability and patient-reported non-adherence seem to be of subordinate importance. Patient-reported non-adherence and IS trough level variables were not correlated; thus, non-adherence should always be measured in a multi-methodological approach. Further research concerning the best combination of non-adherence measures is needed.

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“…There is an obvious relationship between the discontinuity in the use of immunosuppressive drugs and the incidence of transplant failures in the medium and long term[4]. Non-adherence to the transplant medication regimen can lead to graft rejection, post-transplant mortality, increase in healthcare costs, and decrease in quality of life[5,6]. One meta-analysis found non-adherence to medication across all organ transplants to be 22.6%[7].…”

Section: Introductionmentioning

confidence: 99%

Psychological perspective of medication adherence in transplantation

Pasquale

Veroux

Fornaro

et al. 2016

WJT

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AIMTo identify the risk factors and the post-transplant psychological symptoms that affect adherence to therapy in a population of kidney transplant recipients.METHODSThe study examined the psychological variables likely responsible for the non-adherent behavior using a psychological-psychiatric assessment, evaluation of the perception of patients’ health status, and an interview regarding the anti-rejection drug therapy assumption. The study included 74 kidney transplant recipients.RESULTSIndividuals with a higher level of education and more years since transplantation showed better mental balance. Regarding gender, women appeared to be less adherent to therapy. Further, the years since transplantation adversely affected the proper pharmacological assumption. Adherence to therapy did not significantly change with the mental health index.CONCLUSIONThe biopsychosocial illness model provides a conceptual frame of reference in which biological, psychological, and social aspects take on the same importance in the adherence to treatment protocols. For effective management, it is necessary to understand the patients’ personal experiences, their assumptions about the disease, health status perception, and mood, and to identify any “barriers” that could cause them to become noncompliant.

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Adherence in patients in the first year after kidney transplantation and its impact on graft loss and mortality: a cross‐sectional and prospective study

Abstract: Patients with poor adherence to the immunosuppressive medication in the first year after kidney transplantation showed increased likelihood of graft loss and death over 12 years compared with the adherent patients.

Cited by 73 publications

References 49 publications

Nonadherence behaviors and some related factors in kidney transplant recipients

Nonadherence behaviors and some related factors in kidney transplant recipients

Patient-reported non-adherence and immunosuppressant trough levels are associated with rejection after renal transplantation

Psychological perspective of medication adherence in transplantation

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