Prevalence and correlates of self-reported pretransplant nonadherence with medication in heart, liver, and lung transplant candidates.
BACKGROUND
Evidence on prevalence and correlates of pretransplant medication nonadherence (MNA) is limited. The present study explored self-reported prevalence and correlates of MNA before heart, liver, and lung transplantation.


METHODS
This cross-sectional descriptive study included 174 patients: 69 lung, 33 heart, and 72 liver transplant candidates. MNA was assessed by self-report using the following question: "During the past 14 days, how often did you not take your medication?" Patients scoring once or higher on a five-point rating scale were considered to be nonadherent. Correlates of MNA explored were demographics, anxiety and depression (Hospital Anxiety and Depression Inventory), personality traits (NEO Personality Inventory-Revised), perceived health status (Euro-QOL), and social support (Social Support Questionnaire).


RESULTS
Prevalence of pretransplant MNA was 16.7% and was comparable among the three groups. After correction for multiple comparisons (i.e., P=0.01), higher educational level (P=0.006) was related to MNA. Less severe depression (P=0.069), lower scores on the personality trait conscientiousness (P=0.021), and less received social support (P=0.062) tended to be related to MNA. Multiple logistic regression revealed that higher educational level (P=0.008), lower received social support (P=0.013), and lower conscientiousness (P=0.023) were independent predictors of pretransplant MNA.


CONCLUSIONS
Several correlates of MNA allow identification of patients at risk for pretransplant MNA.
Dobbels
Fabienne
F
Center for Health Services and Nursing Research, Faculty of Medicine, Katholieke Universiteit Leuven, B-3000 Leuven, Belgium. fabienne.dobbels@med.kuleuven.ac.be
Vanhaecke
Johan
J
Desmyttere
Ariane
A
Dupont
Lieven
L
Nevens
Frederik
F
De Geest
Sabina
S
D003430:Cross-Sectional Studies; D003710:Demography; D004522:Educational Status; D005260:Female; D016027:Heart Transplantation / Q000523:psychology*; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology*; D016040:Lung Transplantation / Q000523:psychology*; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D015999:Multivariate Analysis; D010349:Patient Compliance; D011300:Preoperative Care; D015995:Prevalence; D012044:Regression Analysis; D016312:Treatment Refusal / Q000706:statistics & numerical data*; D014850:Waiting Lists