Factors Affecting Immunosuppressive Medication Adherence in Liver Transplant Recipients with Poor Adherence: A Qualitative Study

Figures & data

Figure 1 Semi-structured questionnaire.

Figure 2 Content analysis process.

Figure 3 The pattern summarising the study results.

Table 1 Demographic Characteristics of Participants

Participants	Sex	Age	Marital Status	Education	Job	Cause of Transplantation	Time of Liver Transplant	Donor Type	IS Medications
1	Female	33	Married	High School	Not working	Wilson	2001	Deceased	CNI Prednisolone
2	Male	25	Single	Undergraduate	Not working	Glycogen storage disease	2008	Living	CNI
3	Male	52	Married	Primary school	Farmer	Cryptogenic cirrhosis	2005	Deceased	CNI Prednisolone
4	Male	50	Married	High school	Not working	Hepatitis B	2007	Deceased	CNI Prednisolone
5	Male	28	Single	Primary school	Estate agent	Hepatitis B	2006	Deceased	CNI Prednisolone MMF
6	Male	67	Married	Primary school	Farmer	Autoimmune	2009	Deceased	CNI Prednisolone
7	Male	40	Married	High School	Officer	Wilson	2001	Deceased	CNI Prednisolone MMF

Abbreviations: IS, Immunosuppressive; CNI, Calcineurin inhibitors; MMF, Mycophenolate mofetil.

Table 2 Overview of the Study Main Categories, Categories and Sub-Categories

Main Category	Category	Sub-Category
Medication adherence perception	Taking medication on time	Taking medication at the same time
		Adjusting medication time according to mealtime
		Taking medication at regular intervals
	Taking medication at the correct dose	Not skipping the doses
		Taking prescribed medication dose
Types of medication non-adherence	Non-adherence to time	Taking medication late
		Taking medication early
	Non-adherence to dose	Skipping medication dose
Factors affecting medication adherence negatively	Patient-related factors	Forgetfulness
		A medication-dependent life
		Exhausted
		Thought of completely healed
		Disbelief in treatment
	Environmental/social factors	Busy work life
		Travelling
		Lack of family support
	Immunosuppressive therapy-related factors	Length of medication use
		Polypharmacy
		Dosing frequency
		Side effects of the medication
		Different forms and sizes of pills
		Flaws in prescribing medication
Factors affecting medication adherence positively	Patient-related factors	Awareness
		Belief
		Reminder use
		Carrying the medication with them all the times
		Keeping medication at frequently visited places
	Environmental/social factors	Family support
		Monitoring drug blood levels
		Easy access to healthcare professionals