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Modifiable risk factors for non-adherence to immunosuppressants in renal transplant recipients: a cross-sectional study

Modifiable risk factors for non-adherence to immunosuppressants in renal transplant recipients: a cross-sectional study
Modifiable risk factors for non-adherence to immunosuppressants in renal transplant recipients: a cross-sectional study
Background. Non-adherence to immunosuppressants is a major cause of renal transplant failure. Interventions to improve adherence need to target modifiable risk factors.
Methods. Adherence was measured using the ‘gold standard’ measure of electronic monitoring in 58 adult renal transplant recipients from a UK transplant unit. Subjects were identified from a stratified random sample of 153 recipients recruited to a larger cross-sectional study comparing different measures of adherence. Inclusion criteria included age over 18 years and a functioning renal transplant, transplanted 6–63 months previously. Exclusion criteria included residence outside the region served by the unit and inability to give informed consent. Health beliefs, depression and functional status were measured using standardized questionnaires (Beliefs about Medicines Questionnaire, Illness Perception Questionnaire, Revised Clinical Interview Schedule and SF-36) and semi-structured interview. Transplant and demographic details were collected from the notes.
Results. Seven [12%, 95% confidence interval (CI) 4–20%] subjects missed at least 20% of days medication and 15 (26%, 15–37%) missed at least 10% of days. Lower belief in the need for medication and having a transplant from a live donor were the major factors associated with non-adherence. Depression was common, although not strongly associated with non-adherence.
Conclusions. Beliefs about medication are a promising target for interventions designed to improve adherence. The lower adherence in recipients of transplants from live donors needs confirming but may be clinically important in light of the drive to increase live donation.
health beliefs, non-adherence, renal transplant
0931-0509
3144-3149
Butler, Janet A.
2ae17543-2122-4649-a981-dfbadc5946f6
Peveler, Robert C.
93198224-78d9-4c1f-9c07-fdecfa69cf96
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Smith, Peter W. F.
961a01a3-bf4c-43ca-9599-5be4fd5d3940
Horne, Robert
be33adf2-4681-42e4-baed-324ce9dc3d4c
Mason, Juan C.
51b973a9-834b-4008-b2b1-6f6139952e9f
Butler, Janet A.
2ae17543-2122-4649-a981-dfbadc5946f6
Peveler, Robert C.
93198224-78d9-4c1f-9c07-fdecfa69cf96
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Smith, Peter W. F.
961a01a3-bf4c-43ca-9599-5be4fd5d3940
Horne, Robert
be33adf2-4681-42e4-baed-324ce9dc3d4c
Mason, Juan C.
51b973a9-834b-4008-b2b1-6f6139952e9f

Butler, Janet A., Peveler, Robert C., Roderick, Paul, Smith, Peter W. F., Horne, Robert and Mason, Juan C. (2004) Modifiable risk factors for non-adherence to immunosuppressants in renal transplant recipients: a cross-sectional study. Nephrology, Dialysis, Transplantation, 19 (12), 3144-3149. (doi:10.1093/ndt/gfh505).

Record type: Article

Abstract

Background. Non-adherence to immunosuppressants is a major cause of renal transplant failure. Interventions to improve adherence need to target modifiable risk factors.
Methods. Adherence was measured using the ‘gold standard’ measure of electronic monitoring in 58 adult renal transplant recipients from a UK transplant unit. Subjects were identified from a stratified random sample of 153 recipients recruited to a larger cross-sectional study comparing different measures of adherence. Inclusion criteria included age over 18 years and a functioning renal transplant, transplanted 6–63 months previously. Exclusion criteria included residence outside the region served by the unit and inability to give informed consent. Health beliefs, depression and functional status were measured using standardized questionnaires (Beliefs about Medicines Questionnaire, Illness Perception Questionnaire, Revised Clinical Interview Schedule and SF-36) and semi-structured interview. Transplant and demographic details were collected from the notes.
Results. Seven [12%, 95% confidence interval (CI) 4–20%] subjects missed at least 20% of days medication and 15 (26%, 15–37%) missed at least 10% of days. Lower belief in the need for medication and having a transplant from a live donor were the major factors associated with non-adherence. Depression was common, although not strongly associated with non-adherence.
Conclusions. Beliefs about medication are a promising target for interventions designed to improve adherence. The lower adherence in recipients of transplants from live donors needs confirming but may be clinically important in light of the drive to increase live donation.

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More information

Published date: 2004
Keywords: health beliefs, non-adherence, renal transplant

Identifiers

Local EPrints ID: 24286
URI: http://eprints.soton.ac.uk/id/eprint/24286
ISSN: 0931-0509
PURE UUID: 80e4becf-2a90-47c3-b8d4-eeee93697cf0
ORCID for Robert C. Peveler: ORCID iD orcid.org/0000-0001-5596-9394
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850
ORCID for Peter W. F. Smith: ORCID iD orcid.org/0000-0003-4423-5410

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Date deposited: 30 Mar 2006
Last modified: 07 Oct 2020 01:38

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Contributors

Author: Janet A. Butler
Author: Paul Roderick ORCID iD
Author: Robert Horne
Author: Juan C. Mason

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