title: Predicting adherence to immunosuppressant therapy: a prospective analysis of the theory of planned behaviour.
abstract: BACKGROUND
  The objective of this study was to increase the ability to predict renal transplant patients (RTPs) who are most likely to be non-adherent to their immunosuppressant therapy (IST).
  
  
  METHODS
  One hundred and fifty-eight RTPs completed questionnaires assessing Theory of Planned Behaviour (TPB) variables (attitudes, subjective norms and perceived behavioural control) relevant to intentions to adhere to their IST, with the addition of a general measure of past adherence to medical advice. In the full sample, intentions to adhere to IST was the outcome variable. In a subsample of 70 RTPs, the primary outcome was IST adherence.
  
  
  RESULTS
  TPB variables (attitudes, beta = 0.32, P < 0.01; perceived behavioural control, beta = 0.37, P < 0.01; but not subjective norms, beta = -0.001, ns) explained 41% of the variance in intentions to adhere to IST (P < 0.001). Past behaviour predicted perceived behavioural control (beta = 0.67, P < 0.001). Subsample analyses explained 33% (P < 0.001) of the variance in adherence, with intentions and past behaviour being the primary factors (P < 0.05).
  
  
  CONCLUSIONS
  RTPs particularly at risk may be those who have a history of non-adherence to medical advice, especially when they have negative attitudes about IST adherence and feel they have little control over their medication-taking behaviour. Interventions to improve attitudes about IST adherence and control of adherence behaviour are needed.
authors: The University of Arizona College of Pharmacy, Pharmacy-Pulido Center, Tucson, AZ 85721, USA. Chisholm@pharmacy.arizona.edu
authors: Marie A
authors: MA
authors: Chisholm
authors: Gail M
authors: GM
authors: Williamson
authors: Charles E
authors: CE
authors: Lance
authors: Laura L
authors: LL
authors: Mulloy
mesh_terms: D000328:Adult; D000368:Aged; D001519:Behavior; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010349:Patient Compliance; D010465:Perception; D011446:Prospective Studies; D012306:Risk; D011795:Surveys and Questionnaires
chemical_list: D007166:Immunosuppressive Agents