Factors Associated With Adherence To Immunosuppressive Therapy And Barriers In Asian Kidney Transplant Recipients

Abstract

Background

Medication non-adherence is the major risk factor for rejection episodes. The aim of this study was to determine the risk factors associated with adherence to immunosuppressive regimen and its barriers among kidney transplant (KT) recipients.

Methods

A cross-sectional study was performed in two outpatient post-transplant clinics in Mashhad, northeast of Iran. All patients who attended the clinics from August to October 2017 were included. Patients’s knowledge, adherence to immunosuppressive regimen, and quality of life were measured using the Kidney Transplant Understanding Tool, Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS), and SF-12V2 questionnaire, respectively. The barriers in adhering immunosuppressive regimen were investigated by Immunosuppressive Therapy Barriers Scale. Logistic regression was used to screen the significant risk factors of medication non-adherence.

Results

In this study, 244 KT recipients were included with a mean age of 39.6±12.5 years. Based on the BAASIS score, 111 (45.5%) patients were adherent to immunosuppressive regimen. Female patients were more likely to be adherent (OR=0.48, p<0.01). The patients with higher level of quality of life were more likely to follow immunosuppressive medications (OR=1.078, p<0.05). The main barriers were as follows: concurrent use of many immunosuppressants, lack of knowledge about the usefulness of immunosuppressive medications, confusion in medication taking, and difficulty in remembering medication taking.

Conclusion

More than half of the KT recipients were non-adherence to immunosuppressive regimen. These findings highlight the need for designing interventions in order to reduce or eliminate these barriers and consequently increase medication adherence among KT recipients.

Keywords:

• immunosuppressive regimen
• medication adherence
• quality of life
• kidney transplantation

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Factors Associated with Adherence to Immunosuppressive Therapy and Barriers in Asian Kidney Transplant Recipients [Corrigendum]

Abbreviations

IT, information technology; K-TUT, Kidney Transplant Understanding Tool; BAASIS, Basel Assessment of Adherence to Immunosuppressive Medications Scale; ITBS, Immunosuppressive Therapy Barriers Scale; LOS, length of stay.

Ethics Approval And Consent To Participate

This study was approved by the Ethics Committee of Mashhad University of Medical Sciences and Medical School (Grant Number 951645, IR.MUMS.fm.REC.1396.160). The study was carried out in accordance with the principles of the Declaration of Helsinki.

Data Availability

The data used to support the findings of this study are restricted by the Ethics Committee of Mashhad University of Medical Sciences in order to protect patient privacy. Data are available from Saeid Eslami (corresponding author; [email protected]) for researchers who meet the criteria for access to confidential data.

Disclosure

The authors declare that they have no competing interests in this work.