title: Nonadherence consensus conference summary report.
abstract: This report is a summary of a 'Consensus Conference' on nonadherence (NA) to immunosuppressants. Its aims were: (1) to discuss the state-of-the-art on the definition, prevalence and measurement of NA, its risk factors and impact on clinical and economical outcomes and interventions and (2) to provide recommendations for future studies. A two-day meeting was held in Florida in January 2008, inviting 66 medical and allied health adherence transplant and nontransplant experts. A scientific committee prepared the meeting. Consensus was reached using plenary and interactive presentations and discussions in small break-out groups. Plenary presenters prepared a summary beforehand. Break-out group leaders initiated discussion between the group members prior to the meeting using conference calls and e-mail and provided a summary afterward. Conclusions were that NA: (a) is more prevalent than we assume; (b) is hard to measure accurately; (c) tends to confer worse outcomes; (d) happens for a number of reasons, and system-related factors including the patient's culture, the healthcare provider and the setting and (e) it is not currently known how to improve adherence. This consensus report provided some roadmaps for future studies on this complicated, multifaceted problem.
authors.affiliation: Stony Brook University Medical Center, Stony Brook, NY, USA. richard.fine@stonybrook.edu
authors.forename: R N
authors.initials: RN
authors.lastname: Fine
authors.forename: Y
authors.initials: Y
authors.lastname: Becker
authors.forename: S
authors.initials: S
authors.lastname: De Geest
authors.forename: H
authors.initials: H
authors.lastname: Eisen
authors.forename: R
authors.initials: R
authors.lastname: Ettenger
authors.forename: R
authors.initials: R
authors.lastname: Evans
authors.forename: D Lapointe
authors.initials: DL
authors.lastname: Rudow
authors.forename: D
authors.initials: D
authors.lastname: McKay
authors.forename: A
authors.initials: A
authors.lastname: Neu
authors.forename: T
authors.initials: T
authors.lastname: Nevins
authors.forename: J
authors.initials: J
authors.lastname: Reyes
authors.forename: J
authors.initials: J
authors.lastname: Wray
authors.forename: F
authors.initials: F
authors.lastname: Dobbels
mesh_terms: D017281:Cost of Illness; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D010349:Patient Compliance; D015995:Prevalence; D012307:Risk Factors; D014180:Transplantation; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents