Premium
Investigating barriers to immunosuppressant medication adherence in renal transplant patients
Author(s) -
Cossart Amelia Rose,
Staatz Christine Elizabeth,
Campbell Scott Bryan,
Isbel Nicole Maree,
Cottrell William Neil
Publication year - 2019
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13214
Subject(s) - medicine , medication adherence , psychological intervention , cohort , kidney transplantation , locus of control , renal transplant , population , kidney transplant , transplantation , physical therapy , psychiatry , psychology , environmental health , psychotherapist
Aim Immunosuppressant medication non‐adherence can result in allograft rejection and loss. The aim of this study was to investigate the prevalence of non‐adherence and barriers to adherence with immunosuppressant medications, in an adult renal transplant cohort. Methods Kidney transplant recipients completed a self‐report survey consisting of five validated questionnaires (Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS), Beliefs about Medicines Questionnaire, Immunosuppressant Therapy Barrier Scale, Brief‐Illness Perception Questionnaire, and Multidimensional Health Locus of Control Scale), and provided sociodemographic information. Adherence was categorised according to BAASIS, with adherence barriers compared between the groups. Results One hundred and sixty‐one patients in total completed the survey. Eighty‐six participants (55%) were categorised as non‐adherent, with 45% delaying doses, and 25% skipping doses. Non‐adherent patients were more likely to forget doses ( P = 0.005), and more likely to skip doses when their daily routine changed ( P < 0.001) or when short of money ( P = 0.03). Additionally, non‐adherent patients had less self‐reported understanding about their graft than adherent patients ( P = 0.008). Adherence was not associated with a patient's medicine beliefs or perception of locus of control. Conclusion Over half the patients self‐reported non‐adherence. The main modifiable barriers leading to non‐adherence were forgetfulness and skipped doses. Personalised interventions focused on habit forming may improve adherence in this population.