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
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.