title: Identification of medication non-adherence factors in adolescent transplant patients: the patient's viewpoint.
abstract: Studies report a clear association between medication non-adherence and an unfavorable transplant outcome. The adolescent population, in particular, has difficulty adhering to post-transplant medication regimens. The purpose of this study is to identify, categorize and understand the opinions of adolescent transplant patients regarding why they may not take their medications as prescribed. From January to August 2005, nine adolescent kidney transplant patients at an urban medical center were surveyed and asked to rank-order 33 statements regarding their opinions on why adolescents may not take their medications as prescribed. Q-methodology, a powerful tool in subjective study, was used to identify and categorize the viewpoints of adolescents on this subject. Three factors emerged and were labeled to reflect their distinct viewpoints: (1) Medication Issues (e.g. taste, size, frequency, schedule), (2) Troubled Adolescent (e.g. poor home life, depression, overwhelming situation), and (3) Deliberate Non-Adherer (e.g. attention-seeker, infallible attitude). By understanding these different viewpoints and the factors that contribute to them, it may be easier to identify which management approach to non-adherence works best in specific subgroups of patients.
authors.affiliation: Walgreens, Pharmaceutical Care Development, Deerfield, IL 60015, USA. pamelabullington@comcast.net
authors.forename: Pamela
authors.initials: P
authors.lastname: Bullington
authors.forename: Larry
authors.initials: L
authors.lastname: Pawola
authors.forename: Rosemary
authors.initials: R
authors.lastname: Walker
authors.forename: Annette
authors.initials: A
authors.lastname: Valenta
authors.forename: Leslie
authors.initials: L
authors.lastname: Briars
authors.forename: Eunice
authors.initials: E
authors.lastname: John
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D011307:Drug Prescriptions; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000523:psychology*; D008297:Male; D010817:Physician-Patient Relations; D055656:Prescriptions; D011379:Prognosis; D006435:Renal Dialysis / Q000523:psychology*; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016312:Treatment Refusal / Q000523:psychology*
chemical_list: D007166:Immunosuppressive Agents