Long-term decrease in subjective perceived efficacy of immunosuppressive treatment after heart transplantation.
BACKGROUND
Mild, long-term non-compliance with immunosuppressive treatment after organ transplantation is common, and can result in early mortality. One possible source of non-compliance is the belief that the treatment is ineffective or unnecessary. This study investigates patients perception of the efficacy of their immunosuppressive treatment in a sample of heart transplant patients.


METHODS
A questionnaire was given to 67 heart transplant recipients. The first part of the questionnaire addressed health-related behavior and attitude toward the immunosuppressive medication, using self-report questions. In the second part of the questionnaire, participants evaluated the perceived risk of rejection associated with non-compliant behaviors described in 8 scenarios.


RESULTS
The data from the self-report questions showed a mild level of behavioral non-compliance, increasing over time, and a mild level of medication non-compliance. One third of the medication non-compliant patients chose the inefficacy or non-necessity of the treatment as a main cause of non-compliance. The second part of the questionnaire showed that subjective perceived efficacy of the immunosuppressive treatment decreased over time.


CONCLUSIONS
Medication non-compliance is fostered by many factors. One of these is the belief that the treatment is ineffective or unnecessary. This belief increases over time, and could be the result of a non-clinical selective-attention bias.
Cherubini
Paolo
P
Department of Psychology, University of Milan-Bicocca, Piazza Ateneo Nuovo 1, Milan 20126, Italy. paolo.cherubini@unimib.it
Rumiati
Rino
R
Bigoni
Maddalena
M
Tursi
Vincenzo
V
Livi
Ugolino
U
D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000517:prevention & control; D015438:Health Behavior; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010465:Perception; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D007166:Immunosuppressive Agents