Daytime sleepiness in renal transplant recipients is associated with immunosuppressive non‐adherence: a cross‐sectional, multi‐center study. (11th December 2013)

• Record Type: Journal Article
• Authors: Burkhalter, Hanna; Wirz‐Justice, Anna; Cajochen, Christian; Weaver, Terri E.; Steiger, Jürg; Fehr, Thomas; Venzin, Reto M.; De Geest, Sabina
• Is Part Of: Clinical transplantation. Volume 28:Number 1(2014:Jan./Feb.)
• Page Start: 58
• Page End: 66
• Publication Date: 2013-12-11
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12279
• Languages: English
• ISSNs: 0902-0063

Abstract

<abstract abstract-type="main" id="ctr12279-abs-0001"> <title>Abstract</title> <sec id="ctr12279-sec-0001" sec-type="section"> <title>Background</title> <p>The aims of this study were to determine the prevalence of immunosuppressive non‐adherence (NA) in renal transplant patients and describe whether the degree of daytime sleepiness (DS) and depressive symptomatology are associated with immunosuppressive NA.</p> </sec> <sec id="ctr12279-sec-0002" sec-type="section"> <title>Methods</title> <p>Using a cross‐sectional design, 926 home‐dwelling renal transplant recipients who were transplanted at one of three Swiss transplant centers provided data by self‐report. The Basel Assessment of Adherence Scale for immunosuppressive was used to measure the following: taking, timing, and overall NA to immunosuppressive medication. DS was assessed with the Epworth Sleepiness Scale (ESS) (cut‐off ≥6 for DS) and the Swiss Transplant Cohort Study DS item (cut‐off ≥4 for DS), and depressive symptomatology was assessed with the Depression, Anxiety, and Stress Scale (cut‐off>10). An ordinal logistical regression model was applied for statistical analysis.</p> </sec> <sec id="ctr12279-sec-0003" sec-type="section"> <title>Results</title> <p>The prevalence of the ESS‐DS was 51%. NA for taking, timing, and the median overall NA level assessed by 0–100% visual analog scale (VAS) was 16%, 42%, and 0%, respectively. Based on the multivariate analysis, DS was significantly associated (p < 0.001) with taking (1.08 [1.04–1.13]), timing (1.07 [1.03–1.10]), and overall NA (1.09 [1.05–1.13]). Very similar results were found for the Swiss Transplant Cohort Study DS item.</p> </sec> <sec id="ctr12279-sec-0004" sec-type="section"> <title>Conclusion</title> <p>DS is associated with immunosuppressive medication NA in renal transplant recipients. Admittedly, the association's strength is limited.</p> </sec> </abstract>