4CPS-167 Assessment of adherence to immunosuppressive therapy in kidney-transplanted patients. (2nd March 2018)

• Record Type: Journal Article
• Authors: Vengadessane, S; Roy, C Le; Sauvageon, H; Madelaine, I; Pillebout, E; Viglietti, D; Deville, L
• Is Part Of: European journal of hospital pharmacy. Volume 25(2018)Supplement 1
• Page Start: A120
• Page End: A120
• Publication Date: 2018-03-02
• Subjects: Pharmacy -- Periodicals; Hospital pharmacies -- Periodicals; 615.1
• DOI: 10.1136/ejhpharm-2018-eahpconf.258
• Languages: English
• ISSNs: 2047-9956

Abstract

Abstract : Background: The non-adherence with medication regimens is a major public health issue. In kidney-transplanted patients, it results in late acute rejections and graft losses. Purpose: The aim of this study was to identify noncompliant kidney-transplanted patients to their immunosuppressive drugs (ISD), thanks to a self-report instrument, an indirect measure of adherence. Material and methods: From June to October 2017, our hospital's kidney-transplanted recipients answered to Basel Assessment of Adherence to Immunosuppressive Medication Scale (BAASIS). They were interviewed by a pharmacy resident before their consultation with a nephrologist. The self-report's recall period was limited to the last 4 weeks preceding the consultation. Five items were assessed: dose taking (missing a dose), drug holidays (missing two or more doses in a row), timing deviation (postponing 2 hours from the prescribed time), reduction of dose and persistence (stopping completely the intake of ISD). Results: A total of 174 patients answered to the self-report: 37% (65/174) were noncompliant to their ISD. Among them, 18% (12/65) missed one to more than four doses, 62% (40/65) admitted they were used to postponing once to almost daily doses and 18% (12/65) combined both missing and postponing doses. One patient took drug holidays, two reduced their doses themselves and one stopped completely her ISD. Taking ISD at a fixed time was the most common difficulty. The major part of the noncompliant patients (78%) received an initial therapeutic education. This prospective study led by an external person to the transplant team enabled a high participation rate in a short period but excluded patients who did not speak local language. Conclusion: This preliminary study highlighted a large number of transplanted patients who were noncompliant with their ISD. The results of the self-report will be combined with ISD blood levels, a direct measure of adherence. The study will also be deepened by the research of factors influencing the non-compliance. A closer monitoring must be developed as part of therapeutic education, especially for the noncompliant patients in a long-term follow-up. No conflict of interest