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Prevalence and Risk Factors of Non‐Adherence with Immunosuppressive Medication in Kidney Transplant Patients
Author(s) -
Denhaerynck K.,
Steiger J.,
Bock A.,
SchäferKeller P.,
Köfer S.,
Thannberger N.,
De Geest S.
Publication year - 2007
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2006.01611.x
Subject(s) - medicine , dosing , logistic regression , psychological intervention , regimen , kidney transplantation , transplantation , risk factor , kidney disease , kidney transplant , confidence interval , emergency medicine , physical therapy , psychiatry
Non‐adherence with immunosuppressive regimen is a major risk factor for poor outcome after kidney transplantation. Identifying patients at risk for non‐adherence requires understanding the risk factors for non‐adherence. This prospective study included a convenience sample of 249 adult kidney transplant patients >1 year post‐transplant. Non‐adherence was monitored electronically using MEMS®. Selected socio‐economic, therapy‐, patient‐, condition‐ and healthcare team‐related risk factors for non‐adherence were assessed. Period prevalences were expressed as the percent of prescribed doses taken (taking adherence), the percent of correctly dosed days (dosing adherence), the percentage of inter‐dose intervals not exceeding 25% of the prescribed interval (timing adherence), and the number of drug holidays per 100 days (no intake for > 48 h if once daily or for > 24 h if twice daily intake). Testing occurred by simple mixed logistic regression analysis. Factors significant after correction for multiple testing were entered into a multiple logistic regression model. Mean taking, dosing, timing adherence, and drug holidays were 98%, 96%, 93%, and 1.1 days, respectively. Non‐adherence was associated with lower self‐efficacy, higher self‐reported non‐adherence, no pillbox usage, and male gender. Adherence declined between Monday and Sunday. This study provides a framework for identifying patients at risk for non‐adherence and for developing adherence‐enhancing interventions.