Investigating barriers to immunosuppressant medication adherence in renal transplant patients. Issue 1 (16th December 2018)

• Record Type: Journal Article
• Authors: Cossart, Amelia Rose; Staatz, Christine Elizabeth; Campbell, Scott Bryan; Isbel, Nicole Maree; Cottrell, William Neil
• Is Part Of: Nephrology. Volume 24:Issue 1(2019)
• Page Start: 102
• Page End: 110
• Publication Date: 2018-12-16
• Subjects: compliance -- culture -- kidney -- medicine -- transplantation; Nephrology -- Periodicals; Kidneys -- Diseases -- Periodicals; Nephrologists -- Periodicals; 616.61; 616.61
• DOI: 10.1111/nep.13214
• Languages: English
• ISSNs: 1320-5358

Abstract

ABSTRACT: Aim: Immunosuppressant medication non‐adherence can result in allograft rejection and loss. The aim of this study was to investigate the prevalence of non‐adherence and barriers to adherence with immunosuppressant medications, in an adult renal transplant cohort. Methods: Kidney transplant recipients completed a self‐report survey consisting of five validated questionnaires (Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS), Beliefs about Medicines Questionnaire, Immunosuppressant Therapy Barrier Scale, Brief‐Illness Perception Questionnaire, and Multidimensional Health Locus of Control Scale), and provided sociodemographic information. Adherence was categorised according to BAASIS, with adherence barriers compared between the groups. Results: One hundred and sixty‐one patients in total completed the survey. Eighty‐six participants (55%) were categorised as non‐adherent, with 45% delaying doses, and 25% skipping doses. Non‐adherent patients were more likely to forget doses ( P = 0.005), and more likely to skip doses when their daily routine changed ( P < 0.001) or when short of money ( P = 0.03). Additionally, non‐adherent patients had less self‐reported understanding about their graft than adherent patients ( P = 0.008). Adherence was not associated with a patient's medicine beliefs or perception of locus of control. Conclusion: Over half the patients self‐reported non‐adherence. The main modifiable barriers leading to non‐adherence were forgetfulness and skipped doses. Personalised interventions focused on habit forming may improve adherence in this population. Summary at a Glance: This is a single centre study of 161 stable adult kidney transplant recipients, evaluating the incidence of and barriers to immunosuppressant medication adherence. Over 50% of the recipients reported non‐adherence, with a lack of understanding of the renal allograft one of the predominant contributing of factors.