<p>Medication compliance and lifestyle adherence in renal transplant recipients in Kuwait</p>

Abstract

Introduction and aim Kidney transplantation is the optimal treatment choice for end stage renal disease; this option needs a major change in the recipients’ lifestyle and requires strict adherence to medications. The study aim was to assess the compliance of renal transplant patients to medications and lifestyle modifications in the Hamed Al-Essa Organ Transplant Center in Kuwait. Patients and methods One-hundred and twenty renal transplant patients were interviewed for their lifestyle behaviors after transplantation, including transplant adherence to their medications, healthy meals, personal hygiene, physical activity, regular out-patient follow up visits, and preventive measures against infection and cancer, in addition to sexual function. The questionnaire used was created by staff of the Faculty of Medicine, Mansura University, Egypt. Results Sixty percent of the renal transplant patients were compliant with medications and lifestyle. Risk factors associated with poor medication compliance were being Kuwaiti citizens, women, and having had unrelated living donors ( p <0.05). Compliance with medications was associated with less transplant related complications ( p =0.003). Only 15% of the participants were compliant with low-salt diet, 8% with low-fat, and 11% with low-carb. One fourth of patients were compliant with a daily shower and 20% were physically active. More than 70% of the patients were regularly visiting the out-patient clinic. Compliance to preventive measures against infection was observed in 85% of patients but only 5% were avoiding direct sun exposure. Half of the male patients had sexual dysfunction but only half of them were consulting their nephrologists about it. Conclusion Kidney transplant patients in Kuwait had moderate compliance with medications and lifestyle modifications. Closer assessment is needed to identify the risk factors before and after transplantation to avoid any complications associated with non-compliance.

Monitoring Tacrolimus Trough Concentrations During the First Year After Kidney Transplantation: A National Retrospective Cohort Study

“…Possible reasons for the difficulty to keep levels within the target range could be physicians’ nonadherence to the protocol, patients’ nonadherence to their therapy, and the high intrapatient variability in TAC PKs. In a recent study conducted in Kuwait, 60% of 120 KT recipients reported being adherent to their IS medications, which highlights the need for interventions to increase medication adherence among these patients ( Kenawy et al, 2019 ). High variability in TAC level during the first year and throughout 5 years after transplantation was found to be associated with poor allograft outcomes, including late acute rejection, transplant glomerulopathy, and allograft survival ( Sapir-Pichhadze et al, 2014 ; O’Regan et al, 2016 ).…”

Imunosupresinių Vaistų Vartojimas Ir Jo Sąsajos Su Transplantato Laukimo Trukme Bei Laikotarpiu Po Inksto Transplantacijos

“…Nustatyta, kad imunosupresinių vaistų vartojimo režimo nesilaikymas po inksto transplantacijos gali būti būdingas daugiau negu 50 proc. visų inkstų recipientų [2]. Netinkamas imuninę sistemą slopinančių vaistų vartojimas padidina inksto transplantato atmetimo epizodų riziką net 7 kartus [3].…”

“…Ne tik gydytojų pateikiama informacija apie vaistus gali daryti įtaką šiam procesui − pacientų asmeniniai veiksniai, vidinės paskatos, aplinkybės taip pat svarbios. Žinoma, kad gydymo imunosupresiniais vaistais režimo nesilaikymas gali priklausyti nuo amžiaus, lyties, šeimos narių palaikymo, paciento pasitikėjimo gydytojais, vaistų nepageidaujamo poveikio ir kitų veiksnių [2]. Nemažai tyrimų nustatė šių vaistų vartojimo priklausomybę nuo periodo po inksto transplantacijos trukmės [2,4].…”

“…Žinoma, kad gydymo imunosupresiniais vaistais režimo nesilaikymas gali priklausyti nuo amžiaus, lyties, šeimos narių palaikymo, paciento pasitikėjimo gydytojais, vaistų nepageidaujamo poveikio ir kitų veiksnių [2]. Nemažai tyrimų nustatė šių vaistų vartojimo priklausomybę nuo periodo po inksto transplantacijos trukmės [2,4].…”

“…Kitų tyrėjų duomenimis, užmaršumas buvo pagrindinė problema 81 proc. atvejų [2]. Lietuvoje atlikto mūsų tyrimo metu 89,4 proc.…”