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Annals of Behavioral Medicine
Published in: Annals of Behavioral Medicine 1/2012

01-08-2012 | Original Article

Non-adherence to Immunosuppressive Medications in Kidney Transplantation: Intent Vs. Forgetfulness and Clinical Markers of Medication Intake

Authors: Konstadina Griva, Ph.D., Andrew Davenport, FDRC, Michael Harrison, FDRC, Stanton P. Newman, Ph.D.

Published in: Annals of Behavioral Medicine | Issue 1/2012

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Abstract

Background

Although adherence to immunosupressive medication after transplantation is important to maximize good clinical outcomes it remains suboptimal and not well-understood. The purpose of this study was to examine intentional and unintentional non-adherence to immunosuppression medication in kidney transplant patients.

Methods

A cross-sectional sample of N = 218 patients [49.6 ± 12.3 years] recruited in London, UK (1999–2002) completed measures of medication beliefs, quality-of-life, depression, and transplantation-specific emotions. Adherence was measured with self-report and serial immunosuppressive assays.

Results

Intentional non-adherence was low (13.8 %) yet 62.4 % admitted unintentional non-adherence and 25.4 % had sub-target immunosuppressive levels. The risk of sub-target serum immunosuppressive levels was greater for patients admitting unintentional non-adherence (OR = 8.4; p = 0.004). Dialysis vintage, doubts about necessity, and lower worry about viability of graft explained R 2 = 16.1 to 36 % of self-report non-adherence. Depression was related only to intentional non-adherence.

Conclusions

Non-adherence is common in kidney transplantation. Efforts to increase adherence should be implemented by targeting necessity beliefs, monitoring depression, and promoting strategies to decrease forgetfulness.
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Metadata
Title
Non-adherence to Immunosuppressive Medications in Kidney Transplantation: Intent Vs. Forgetfulness and Clinical Markers of Medication Intake
Authors
Konstadina Griva, Ph.D.
Andrew Davenport, FDRC
Michael Harrison, FDRC
Stanton P. Newman, Ph.D.
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
Annals of Behavioral Medicine / Issue 1/2012
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-012-9359-4

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