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Self‐reported non‐adherence to immunosuppressive medication in adult lung transplant recipients—A single‐center cross‐sectional study
Author(s) -
Drick Nora,
Seeliger Benjamin,
Fuge Jan,
Tudorache Igor,
Greer Mark,
Welte Tobias,
Haverich Axel,
Gottlieb Jens
Publication year - 2018
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.13214
Subject(s) - medicine , medication adherence , cross sectional study , observational study , lung transplantation , single center , transplantation , immunosuppression , intensive care medicine , pathology
Background Non‐adherence to immunosuppressive treatment following solid organ transplantation is common and often associated with poorer outcomes. Non‐adherence is difficult to assess, and barriers to adherence in lung transplant (LTx) recipients remain to be elucidated. Methods A single‐center cross‐sectional observational study of all LTx recipients attending our department between 07/2013 and 05/2014 was performed. Non‐adherence was assessed using patient self‐reporting, including Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS) along with healthcare worker (HCW) judgment and reasons for non‐adherence by the Immunosuppressive Therapy Barriers Scale. Results A total of 138/504 patients (27.4%) self‐reported non‐adherence to immunosuppressive medication. HCW scored 96/504 patients (19.1%) as poorly adherent. Self‐reported non‐adherence increased with increasing interval after transplantation. The main reason for non‐adherence was punctuality (75%), with only 11% reporting drug holidays. Explanations for non‐adherence were primarily related to self‐organization and difficulties incorporating medication into daily routine. There were no significant differences in medication knowledge or variation in trough levels. Conclusions This study confirms that non‐adherence in LTx recipients is frequent according to self‐report. Barriers are self‐organization and difficulties incorporating medication into daily routine. Social and behavioral support is needed to overcome non‐adherence. (ClinicalTrials.gov number: NCT01889017).