Exploration of Adherence to the Immunosuppressive Medication in Kidney Transplant Recipients Based on Theory of Planned Behavior

Yang, Luo; Liu, Hongxia; Hu, Yue; Zhang, Bei; Peng, Fucong; Wei, Changyun; Wang, Ruiting

doi:10.1177/10547738221096550

Cited by 3 publications

(2 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Perceived behavioral control tends to be an important predictor of nonadherence [ 20 ]. Greater perceived behavioral control played an active part in the intentions to self-efficacy and medicine adherence [ 49 ]. In addition, the more susceptibility KTRs perceived to transplant rejection, the more adherent they were.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Development and validation of a LASSO-based prediction model for immunosuppressive medication nonadherence in kidney transplant recipients

Dong,

Zhu,

Zhao

et al. 2023

Renal Failure

View full text Add to dashboard Cite

Introduction To establish a prediction model to predict immunosuppressive medication (IM) nonadherence in kidney transplant recipients (KTRs) based on a combined theory framework. Methods This polycentric, cross-sectional study included 1191 KTRs from October 2020 to February 2021 in China, with 1011 KTRs enrolled in the derivation set and 180 in the external validation set. Variables selected based on the combined theory of planned behavior (TPB)/health belief model (HBM) theory were analyzed by the least absolute shrinkage and selection operator (LASSO). Internal 10 cross-validation was conducted to determine the optimal lambda value. The receiver operating characteristic (ROC) curve, specificity, and sensitivity were used to evaluate the prediction model, and further assessment was run by external validation. Results IM nonadherence rate was 38.48% in the derivation set and 37.22% in the validation set. The LASSO model was developed with eight predictors for IM nonadherence: age, preoperative drinking history, education, marital status, perceived barriers, social support, perceived behavioral control, and perceived susceptibility. The model demonstrated acceptable discrimination with the area under the ROC curve of 0.797 (95% CI: 0.745–0.850) in the internal validation set and 0.757 (95% CI: 0.684–0.829) in the external validation set. The specificity and sensitivity in the internal validation and external validation set were 0.741, 0.748, 0.673, and 0.716, respectively. Conclusions The LASSO model was developed to guide identifying high-risk nonadherent patients and timely and effective interventions to improve their prognosis and survival.

show abstract

Section: Discussionmentioning

confidence: 99%

“…was widely used to assess the following five TPB variables related to intentions to adhere to medication: attitudes, intentions, perceived behavioral control, subjective norms, and past behavior [ 20 ]. Cronbach’s α of each variable was 0.744, 0.703, 0.668, 0.762, and 0.861 [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

Development and validation of a LASSO-based prediction model for immunosuppressive medication nonadherence in kidney transplant recipients

Dong,

Zhu,

Zhao

et al. 2023

Renal Failure

View full text Add to dashboard Cite

show abstract

Profiles of Immunosuppressive Nonadherence and Association between Medication Adherence and Tacrolimus Intra-patient Variability Among Stable Kidney Transplant Recipients

Zou,

Dai,

Hou

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Understanding the modifiable correlates and risk factors for medication non-adherence is essential to develop interventions to improve adherence and thus long-term transplantation outcomes. Methods This single-center cross-sectional study collected 409 validated questionnaires of renal transplant recipients followed in outpatient clinics. The incidence of nonadherence to immunosuppressive therapy (implementation phase) was calculated. Multilevel correlates associated with nonadherence were collected to analyze multilevel correlates of nonadherence in kidney transplant recipients. The relationship between nonadherence and recipient outcomes was also explore. Results The incidence of nonadherence to immunosuppressive drugs in renal transplant recipients was 41.6%. Multiple logistic regression analysis showed that 4 variables were positively associated with immunosuppressive nonadherence, namely without steady partner (OR: 1.722; 95%CI: 1.034–2.866), post-transplant years (OR: 1.240; 95%CI: 1.134–1.356), twice-daily immunosuppressive regimen (OR: 5.522 95%CI: 2.857–10.671), Tac IPV (OR: 1.029 95%CI: 1.007–1.052). There was a significant difference in Tac IPV between the adherent and nonadherent groups. The incidence of rejection was 4.2% (10/239) in the adherent group and 12.4% (21/170) in the nonadherent group(p = 0.002). In addition, nonadherence (OR: 2.967, 95%CI: 1.248–7.058) and Tac IPV (OR: 1.030, 95%CI: 1.001–1.060) were positively correlated with episodes of rejection. Conclusion The higher incidence of immunosuppression nonadherence in renal transplant recipients correlates with lacking a steady domestic partner, longer time since the transplantation, higher frequency of immunosuppressive dosing, and higher Tac IPV. In addition, nonadherence and higher tacrolimus IPV were correlated with episodes of rejection. Tacrolimus IPV can be an additional instrument for identifying recipients at risk of nonadherence.

show abstract

Immunosuppressant nonadherence profile in kidney transplant recipients and the impact of medication adherence on transplant outcomes

Zhi-yu,

Lin-rui,

Chen-zhen

et al. 2024

Front. Pharmacol.

View full text Add to dashboard Cite

BackgroundDespite the fact that 1-year graft and recipient survival rates are above 90% in most transplant centers, improving long-term graft survival remains an important challenge. Immunosuppressant nonadherence has been recognized as one of the important risk factors for long-term graft failure. Understanding the modifiable correlates and risk factors for medication non-adherence is essential to develop interventions to improve adherence and thus long-term transplantation outcomes.MethodsThis study conducted a questionnaire survey on 431 renal transplant recipients who were followed up in the outpatient clinic between January 2022 and January 2023, and 409 valid questionnaires were returned. The BAASIS questionnaire was used to assess the prevalence of nonadherence to immunosuppressive therapy (implementation phase) in Chinese renal transplant recipients and to explore the multilevel correlates of immunosuppressive nonadherence. The BAASIS questionnaire was used to categorize renal transplant recipients into adherent (n = 239) and non-adherent (n = 170) groups, and a prospective cohort study with a 1-year follow-up was conducted to explore the impact of immunosuppressant non-adherence on clinical outcomes.ResultsThe prevalence of nonadherence to immunosuppressant therapy in renal transplant recipients in this study was as high as 41.6%. The number of years post-transplant (OR: 1.240, 95% CI: 1.136–1.353, p < 0.001) and the frequency of twice-daily dosing (OR: 5.145, 95% CI: 2.690–9.840, p < 0.001) were positively correlated with immunosuppressive nonadherence. There was a significant difference in TAC IPV (Intra-individual Variability) between the adherent and nonadherent groups (22.7 ± 8.7 vs. 25.4 ± 11.6, p = 0.010). Renal function remained stable during the follow-up period in the recipients in the adherence group and tended to decrease in the recipients in the non-adherence group (F = 4.932, p = 0.001). The rates of graft loss (7.1% vs. 1.7%, p = 0.006) and rejection (12.4% vs. 4.2%, p = 0.002) were higher in the nonadherent group than in the adherent group.ConclusionLonger time post-transplant and higher frequency of immunosuppressive dosing were positively associated with nonadherence to immunosuppressives medication. Immunosuppressant nonadherence was associated with adverse graft outcomes.

show abstract

Exploration of Adherence to the Immunosuppressive Medication in Kidney Transplant Recipients Based on Theory of Planned Behavior

Cited by 3 publications

References 33 publications

Development and validation of a LASSO-based prediction model for immunosuppressive medication nonadherence in kidney transplant recipients

Development and validation of a LASSO-based prediction model for immunosuppressive medication nonadherence in kidney transplant recipients

Profiles of Immunosuppressive Nonadherence and Association between Medication Adherence and Tacrolimus Intra-patient Variability Among Stable Kidney Transplant Recipients

Immunosuppressant nonadherence profile in kidney transplant recipients and the impact of medication adherence on transplant outcomes

Contact Info

Product

Resources

About