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Self‐reported non‐adherence to immune‐suppressant therapy in liver transplant recipients: demographic, interpersonal, and intrapersonal factors
Author(s) -
Lamba Sangeeta,
Nagurka Roxanne,
Desai Kunj K.,
Chun Shaun J.,
Holland Bart,
Koneru Baburao
Publication year - 2011
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/j.1399-0012.2011.01489.x
Subject(s) - intrapersonal communication , medicine , transplantation , demographics , liver transplantation , immune system , interpersonal communication , immunology , demography , psychology , social psychology , sociology
Lamba S, Nagurka R, Desai KK, Chun SJ, Holland B, Koneru B. Self‐reported non‐adherence to immune‐suppressant therapy in liver transplant recipients: demographic, interpersonal, and intrapersonal factors.
Clin Transplant 2011 DOI: 10.1111/j.1399‐0012.2011.01489.x.
© 2011 John Wiley & Sons A/S. Abstract: Adherence to immune suppressants and follow‐up care regimen is important in achieving optimal long‐term outcomes after organ transplantation. To identify patients most at risk for non‐adherence, this cross‐sectional, descriptive study explores the prevalence and correlates of non‐adherence to immune‐suppressant therapy among liver recipients. Anonymous questionnaires mailed consisted of the domains: (i) adherence barriers to immune suppressants, (ii) immune suppressants knowledge, (iii) demographics, (iv) social support, (v) medical co‐morbidities, and (vi) healthcare locus of control and other beliefs. Overall response was 49% (281/572). Data analyzed for those transplanted within 10 yr of study reveal 50% (119/237) recipients or 9.2/100 person years reporting non‐adherence. Non‐adherence was reported highest in the 2–5 yr post‐transplant phase (69/123, 56%). The highest immune‐suppressant non‐adherence rates were in recipients who are: divorced (26/34, 76%, p = 0.0093), have a history of substance or alcohol use (42/69, 61%, p = 0.0354), have mental health needs (50/84, 60%, p = 0.0336), those who missed clinic appointments (25/30, 83%, p < 0.0001), and did not maintain medication logs (71/122, 58%, p = 0.0168). Respondents who were non‐adherent with physician appointments were more than four and a half times as likely (OR 4.7, 95% CI 1.5–14.7, p = 0.008) to be non‐adherent with immune suppressants. In conclusion, half of our respondents report non‐adherence to immune suppressants. Factors identified may assist clinicians to gauge patients’ non‐adherence risk and target resources.