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Patient‐reported medication adherence and tolerability: Results of a prospective observational study
Author(s) -
Keys Alison E,
Pilch Nicole A.,
Perez Caroline,
Patel Neha,
Meadows Holly,
Fleming James N.,
Taber David J.
Publication year - 2021
Publication title -
journal of the american college of clinical pharmacy
Language(s) - English
Resource type - Journals
ISSN - 2574-9870
DOI - 10.1002/jac5.1365
Subject(s) - medicine , tolerability , observational study , medication adherence , immunosuppression , odds ratio , transplantation , prospective cohort study , adverse effect
Purpose Medication nonadherence (MNA) is a major contributor to late allograft loss in transplantation. Immunosuppression therapy is highly effective at preventing rejection yet presents a substantial toxicity burden. There is limited data assessing the correlation between MNA and tolerability in transplant. Methods This was a single‐center prospective observational longitudinal study including adult transplant recipients. Consenting transplant patients were administered a survey assessing adherence (Morisky Med Adherence Survey, MMAS) and a medication tolerability assessment (modified MTSOSD‐59R). Participants were emailed surveys every 2 months (repeated measures) for a maximum of 36‐months. Generalized linear models (logistic and Gaussian) were used for analyses, accounting for correlation by repeated measures and time. Results There were 472 assessments completed in 268 transplant recipients. Mean post‐transplant time was 4.0 ± 5.4 years; medium or high adherence was reported in 77.4% of responses. Medication side effect burden improved over time, while medication adherence had a decreasing trend over time. Self‐reported medication side effect burden significantly correlated with medication adherence. For every one‐point increase in side effect burden there was a 1.3% corresponding decrease in odds of reporting medium to high adherence. Those with higher than average medication side effect burden had a 57% lower odds of reporting medium to high adherence. Conclusion MNA is common in transplant recipients, regardless of transplant type. Self‐reported medication side effect burden is significantly correlated with medication adherence, offering a potential area of intervention for clinicians to improve non‐adherence rates.