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4CPS-167 Assessment of adherence to immunosuppressive therapy in kidney-transplanted patients
  1. S Vengadessane1,
  2. C Le Roy1,
  3. H Sauvageon1,
  4. I Madelaine1,
  5. E Pillebout2,
  6. D Viglietti2,
  7. L Deville1
  1. 1Saint Louis, Pharmacy, Paris, France
  2. 2Saint Louis, Nephrology, Paris, France


Background The non-adherence with medication regimens is a major public health issue. In kidney-transplanted patients, it results in late acute rejections and graft losses.

Purpose The aim of this study was to identify noncompliant kidney-transplanted patients to their immunosuppressive drugs (ISD), thanks to a self-report instrument, an indirect measure of adherence.

Material and methods From June to October 2017, our hospital’s kidney-transplanted recipients answered to Basel Assessment of Adherence to Immunosuppressive Medication Scale (BAASIS). They were interviewed by a pharmacy resident before their consultation with a nephrologist. The self-report’s recall period was limited to the last 4 weeks preceding the consultation. Five items were assessed: dose taking (missing a dose), drug holidays (missing two or more doses in a row), timing deviation (postponing 2 hours from the prescribed time), reduction of dose and persistence (stopping completely the intake of ISD).

Results A total of 174 patients answered to the self-report: 37% (65/174) were noncompliant to their ISD. Among them, 18% (12/65) missed one to more than four doses, 62% (40/65) admitted they were used to postponing once to almost daily doses and 18% (12/65) combined both missing and postponing doses. One patient took drug holidays, two reduced their doses themselves and one stopped completely her ISD. Taking ISD at a fixed time was the most common difficulty. The major part of the noncompliant patients (78%) received an initial therapeutic education. This prospective study led by an external person to the transplant team enabled a high participation rate in a short period but excluded patients who did not speak local language.

Conclusion This preliminary study highlighted a large number of transplanted patients who were noncompliant with their ISD. The results of the self-report will be combined with ISD blood levels, a direct measure of adherence. The study will also be deepened by the research of factors influencing the non-compliance. A closer monitoring must be developed as part of therapeutic education, especially for the noncompliant patients in a long-term follow-up.

No conflict of interest

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