Follow-Up Factors Contribute to Immunosuppressant Adherence in Kidney Transplant Recipients

Figures & data

Table 1 Basic Characteristics of the Study Population and Differences Regarding Adherence to Immunosuppressants

Variables	Categories	Total (n (%))	Non-Adherent (n (%))	Adherent (n (%))	P-value^#
Age (years) Mean (SD)		42.7 (10.3)	42.5 (9.6)	42.8 (10.9)	0.777
Sex	Female	95 (33.0)	47 (33.8)	48 (32.2)	0.803
	Male	193 (67.0)	92 (66.2)	101 (67.8)
Secondary kidney transplantation		275 (95.5)	131 (94.2)	144 (96.6)	0.243
Time since transplantation (years)	≤1	61 (21.2)	15 (10.8)	46 (30.9)	<0.001
	1–5	128 (44.4)	66 (47.5)	62 (41.6)
	5–10	48 (16.7)	24 (17.3)	24 (16.1)
	≥10	51 (17.7)	34 (24.5)	17 (11.4)
Employment status	Employed	154 (53.5)	86 (61.9)	68 (45.6)	0.004
	Unemployed	134 (46.5)	53 (38.1)	81 (54.4)
Residence	Rural	55 (19.1)	25 (18.0)	30 (20.1)	0.377
	Urban	233 (80.9)	114 (82.0)	119 (79.9)
Education	Middle school and below	41 (14.2)	19 (13.7)	22 (14.8)	0.513
	High school	135 (46.9)	70 (50.4)	65 (43.6)
	Bachelor and above	112 (38.9)	50 (36.0)	62 (41.6)
Marital status	Single/divorce	79 (27.4)	35 (25.2)	44 (29.5)	0.244
	Married	209 (72.6)	104 (74.8)	105 (70.5)
Insurance	Self-paying	10 (3.5)	6 (4.3)	4 (2.7)	0.572
	NRCMS	33 (11.5)	18 (12.9)	15 (10.1)
	URBMI/UEBMI	245 (85.1)	115 (82.7)	130 (87.2)
Economic burden	Free	36 (12.5)	17 (12.2)	19 (12.8)	0.478
	Mild	92 (31.9)	40 (28.8)	52 (34.9)
	Moderate	96 (33.3)	46 (33.1)	50 (33.6)
	Heavy	64 (22.2)	36 (25.9)	28 (18.8)
ISM	Tacrolimus/MPA/Pred	212 (73.6)	101 (72.7)	111 (74.5)	0.475
	CsA/MPA/Pred	49 (17.0)	27 (19.4)	22 (14.8)
	Others	27 (9.4)	11 (7.9)	16 (10.7)
Diabetes		29 (10.1)	18 (12.9)	11 (7.4)	0.085
Hypertension		167 (58.0)	82 (59.0)	85 (57.0)	0.415
Hyperuricemia		100 (34.7)	56 (40.3)	44 (29.5)	0.036
Hyperlipemia		70 (24.3)	43 (30.9)	27 (18.1)	0.008
BKV viruria		28 (9.7)	11 (7.9)	17 (11.4)	0.212
No. non-ISA medications (n)	0	36 (12.5)	23 (16.5)	13 (8.7)	0.096
	1–3	167 (58.0)	80 (57.6)	87 (58.4)
	>3	85 (29.5)	36 (25.9)	49 (32.9)
No. times for taking medicines per day (n)	≤3	147 (51.0)	69 (49.6)	78 (52.3)	0.754
	3–5	96 (33.3)	46 (33.1)	50 (33.6)
	>5	45 (15.6)	24 (17.3)	21 (14.1)
Use medicine box	No	79 (27.4)	39 (28.1)	40 (26.8)	0.461
	Yes	209 (72.6)	100 (71.9)	109 (73.2)

Notes: ^#Performed as t-test for continuous variables, and Chi-square test or Fisher exact test for categorical variables.

Table 2 Prevalence of Adherence Measured with BAASIS©

Adherence Behavior in Previous 4 Weeks	n	%
1A. Taking no-adherence
No	217	75.3
Yes	71	24.7
1B. Drug holidays
No	274	95.1
Yes	14	4.8
2. Timing no-adherence
No	192	66.7
Yes	96	33.3
3. Dose alterations
No	272	94.4
Yes	16	5.6
4. Discontinuation
No	279	96.9
Yes	9	3.1
Total number categorized as showing no-adherence^†	139	48.3

Notes: ^†Sum of participants answering affirmatively to 1A, 1B, 2, 3, and 4.

Table 3 Follow-Up Factors Stratified by ISM Adherence

	Total	Non-Adherence	Adherence	P-value
With a fixed doctor for follow-up (n (%))
No	70	48 (34.5)	22 (14.8)	<0.001
Yes	218	91 (65.5)	127 (85.2)
Follow-up adherence
No	142	76 (54.7)	66 (44.3)	0.099
Yes	146	63 (45.3)	83 (55.7)

Figure 1 The relationship between each dimension of the BAASIS scale and follow-up factors. (A) Difference in fixed follow-up physicians between the adherence and non-adherence group; (B) Difference in follow-up adherence between the adherence and non-adherence group. *P<0.05; **P<0.01; ***P<0.001.

Figure 2 Factors associated with immunosuppressant medication adherence.