Relationship between Immunosuppressive Medications Adherence and Quality of Life and Some Patient Factors in Renal Transplant Patients in Iran

Abstract

Background & Aim:About organ transplant, immunosuppressive medications adherence is a critical issue, because non-adherence to these medications causes rejection, reduces quality of life and increases treatment cost and mortality rate. Among these, the quality of life is deemed very important to evaluate treatment result and also it can be useful for discovering non adherence. The aim this study was to assess the relationship between medication adherence and quality of life and some patient factors in renal transplant patients.Methods:The study was a descriptive-correlational design and was done on renal transplant patients over 18 who had undergone surgery for over 3 months, and were inclined to participate. Sample size was 230 people and sampling was convenience. Quality of life questionnaire in renal transplant patients and Immunosuppressant Therapy Adherence Scale were filled by patients and the data was analyzed by SPSS15 software.Results:It showed that the mean score of quality of life in renal transplant patients was 21.65±4.03 and 57.8% of them did not adhere to immunosuppressive medications. Results of correlation between scores of immunosuppressive medication adherence and Quality of life showed that there were significant correlation in 3 dimensions of 4: health performance (p≤0.0001 & rETA=0.23), social-economic (p=0.001 & rETA=0.15), psychological-spiritual (p=0.011 & rETA=0.15), also logistic test showed significant relationship between immunosuppressive medication adherence and number of transplantation (β=1.04, p= 0.048).Conclusion:According to the results, health care providers i.e. nurses must note to medication adherence as a health enhancement factor while treating and educating to these patients.

Self‐efficacy beliefs, locus of control, religiosity and non‐adherence to immunosuppressive medications in kidney transplant patients

“…Some studies have already shown that high religiosity is associated with adherence in some contexts, such as chronic diseases . In KT patients, a study in Iran found that a higher psychological‐spiritual dimension of quality of life was correlated with adherence, which is in accordance with our findings . In fact, religion plays an important role for the patient with chronic kidney disease at an advanced stage, most of the time ameliorating the doctor‐patient relationship, quality of life and coping with the disease .…”

Investigating barriers to immunosuppressant medication adherence in renal transplant patients

“…Successful long‐term kidney graft outcomes remain suboptimal, with immunosuppressant medication non‐adherence considered an important contributing factor . Currently, immunosuppressant medication non‐adherence in renal transplant patients is reported to be between 20% and 60% …”

“…5 Currently, immunosuppressant medication non-adherence in renal transplant patients is reported to be between 20% and 60%. [6][7][8][9] Several barriers to immunosuppressant adherence have been consistently reported including: a complex dosing regimen, 10,11 patient age (<35 years), 12,13 forgetfulness, 14,15 beliefs (about medicines, the transplant, and who/what controls an individual's health), 6,16 depression or anxiety, 17 high medication cost, 1,11 perceived/actual side-effects, 4,15,18 and lack of social support. 4 Identifying barriers impacting adherence is crucial to understanding how best to deliver interventions to address these barriers.…”

Psychological and Psychopathological Aspects of Kidney Transplantation: A Systematic Review

“…The data available to date suggest that pre and post-transplant screening process must include both a medical evaluation and a thorough psychological and psychiatric assessment for a better therapeutic adherence. Adherence is a very important issue in the medical care of kidney transplant patients (51). The life style and quality of life of a transplanted subject represent a key point, and it is essential to adhere to the therapy and prescribed behaviors (34,79).…”