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Medication understanding, non‐adherence, and clinical outcomes among adult kidney transplant recipients
Author(s) -
Patzer Rachel E.,
Serper Marina,
Reese Peter P.,
Przytula Kamila,
Koval Rachel,
Ladner Daniela P.,
Levitsky Josh M.,
Abecassis Michael M.,
Wolf Michael S.
Publication year - 2016
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12821
Subject(s) - medicine , dosing , psychological intervention , health literacy , kidney transplant , kidney transplantation , transplantation , tacrolimus , medication adherence , physical therapy , health care , psychiatry , economics , economic growth
Abstract We sought to evaluate the prevalence of medication understanding and non‐adherence of entire drug regimens among kidney transplantation ( KT ) recipients and to examine associations of these exposures with clinical outcomes. Structured, in‐person interviews were conducted with 99 adult KT recipients between 2011 and 2012 at two transplant centers in Chicago, IL ; and Atlanta, GA . Nearly, one‐quarter (24%) of participants had limited literacy as measured by the Rapid Estimate of Adult Literacy in Medicine test; patients took a mean of 10 ( SD =4) medications and 32% had a medication change within the last month. On average, patients knew what 91% of their medications were for (self‐report) and demonstrated proper dosing (via observed demonstration) for 83% of medications. Overall, 35% were non‐adherent based on either self‐report or tacrolimus level. In multivariable analyses, fewer months since transplant and limited literacy were associated with non‐adherence (all P <.05). Patients with minority race, a higher number of medications, and mild cognitive impairment had significantly lower treatment knowledge scores. Non‐white race and lower income were associated with higher rates of hospitalization within a year following the interview. The identification of factors that predispose KT recipients to medication misunderstanding, non‐adherence, and hospitalization could help target appropriate self‐care interventions.