Nonadherence behaviors and some related factors in kidney transplant recipients

Hedayati, Pari; Shahgholian, Nahid; Ghadami, Ahmad

doi:10.4103/ijnmr.ijnmr_220_15

Cited by 20 publications

(45 citation statements)

References 24 publications

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“…We found that lower education and higher BMI are both associated with lower adherence to dietary recommendations. This result is consistent with findings from Hedayati et al 7 who showed in their study that patients with lower social support and education levels have lower adherence to lifestyle recommendations. Social determinants of health are well-known risk factors for access to kidney transplant, 33 , 73 and our study suggests that such factors may play a role in post-KT care as well.…”

Section: Discussionsupporting

confidence: 93%

“… 4 , 5 Current literature and interventions have focused overwhelmingly on medication adherence with few looking at adherence to healthcare follow-up 4 , 5 or lifestyle. 7 , 8 From a patient perspective, studies have demonstrated that patients tend to be more adherent to medications than to lifestyle recommendations. 6 , 7 …”

mentioning

confidence: 99%

“… 7 , 8 From a patient perspective, studies have demonstrated that patients tend to be more adherent to medications than to lifestyle recommendations. 6 , 7 …”

mentioning

confidence: 99%

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Medication, Healthcare Follow-up, and Lifestyle Nonadherence: Do They Share the Same Risk Factors?

Litvinovich

Leyva

et al. 2021

Transplantation Direct

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Background. Barriers to medication adherence may differ from barriers in other domains of adherence. In this study, we assessed the association between pre–kidney transplantation (KT) factors with nonadherent behaviors in 3 different domains post-KT. Methods. We conducted a prospective cohort study with patient interviews at initial KT evaluation (baseline—nonadherence predictors in sociodemographic, condition-related, health system, and patient-related psychosocial factors) and at ≈6 mo post-KT (adherence outcomes: medications, healthcare follow-up, and lifestyle behavior). All patients who underwent KT at our institution and had ≈6-mo follow-up interview were included in the study. We assessed nonadherence in 3 different domains using continuous composite measures derived from the Health Habit Survey. We built multiple linear and logistic regression models, adjusting for baseline characteristics, to predict adherence outcomes. Results. We included 173 participants. Black race (mean difference in adherence score: −0.72; 95% confidence interval [CI], −1.12 to −0.32) and higher income (mean difference: −0.34; 95% CI, −0.67 to −0.02) predicted lower medication adherence. Experience of racial discrimination predicted lower adherence (odds ratio, 0.31; 95% CI, 0.12–0.76) and having internal locus of control predicted better adherence (odds ratio, 1.46; 95% CI, 1.06–2.03) to healthcare follow-up. In the lifestyle domain, higher education (mean difference: 0.75; 95% CI, 0.21–1.29) and lower body mass index (mean difference: −0.08; 95% CI, −0.13 to −0.03) predicted better adherence to dietary recommendations, but no risk factors predicted exercise adherence. Conclusions. Different nonadherence behaviors may stem from different motivation and risk factors (eg, clinic nonattendance due to experiencing racial discrimination). Thus adherence intervention should be individualized to target at-risk population (eg, bias reduction training for medical staff to improve patient adherence to clinic visit).

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Section: Discussionsupporting

confidence: 93%

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confidence: 99%

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Medication, Healthcare Follow-up, and Lifestyle Nonadherence: Do They Share the Same Risk Factors?

Litvinovich

Leyva

et al. 2021

Transplantation Direct

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“…immunosuppressants) 1. The WHO defines medication adherence as a match between patient’s behavior and the medical team’s recommendations 2. Medication non-adherence is the major risk factor for rejection episodes 3.…”

Section: Introductionmentioning

confidence: 99%

<p>Factors Associated With Adherence To Immunosuppressive Therapy And Barriers In Asian Kidney Transplant Recipients</p>

Ganjali¹,

Sabbagh²,

Nazemiyan³

et al. 2019

ITT

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BackgroundMedication non-adherence is the major risk factor for rejection episodes. The aim of this study was to determine the risk factors associated with adherence to immunosuppressive regimen and its barriers among kidney transplant (KT) recipients.MethodsA cross-sectional study was performed in two outpatient post-transplant clinics in Mashhad, northeast of Iran. All patients who attended the clinics from August to October 2017 were included. Patients’s knowledge, adherence to immunosuppressive regimen, and quality of life were measured using the Kidney Transplant Understanding Tool, Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS), and SF-12V2 questionnaire, respectively. The barriers in adhering immunosuppressive regimen were investigated by Immunosuppressive Therapy Barriers Scale. Logistic regression was used to screen the significant risk factors of medication non-adherence.ResultsIn this study, 244 KT recipients were included with a mean age of 39.6±12.5 years. Based on the BAASIS score, 111 (45.5%) patients were adherent to immunosuppressive regimen. Female patients were more likely to be adherent (OR=0.48, p<0.01). The patients with higher level of quality of life were more likely to follow immunosuppressive medications (OR=1.078, p<0.05). The main barriers were as follows: concurrent use of many immunosuppressants, lack of knowledge about the usefulness of immunosuppressive medications, confusion in medication taking, and difficulty in remembering medication taking.ConclusionMore than half of the KT recipients were non-adherence to immunosuppressive regimen. These findings highlight the need for designing interventions in order to reduce or eliminate these barriers and consequently increase medication adherence among KT recipients.

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“…Many factors can contribute to medication or lifestyle compliance issues; these include internal factors such as age and gender and external factors such as family support and patient trust in the healthcare system. Other factors such as medication side effects and recommended food types must be considered as well 12…”

Section: Introductionmentioning

confidence: 99%

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

Kenawy¹,

Gheith²,

Al-Otaibi³

et al. 2019

PPA

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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.

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Nonadherence behaviors and some related factors in kidney transplant recipients

Cited by 20 publications

References 24 publications

Medication, Healthcare Follow-up, and Lifestyle Nonadherence: Do They Share the Same Risk Factors?

Medication, Healthcare Follow-up, and Lifestyle Nonadherence: Do They Share the Same Risk Factors?

<p>Factors Associated With Adherence To Immunosuppressive Therapy And Barriers In Asian Kidney Transplant Recipients</p>

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

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