title: Medication adherence in older renal transplant recipients.
abstract: This project examined patterns, predictors, and outcomes of medication adherence in a convenience sample of 37 renal transplant recipients aged 55 years or older in a Mid-Southern U.S. facility using an exploratory, descriptive, longitudinal design. Electronic monitoring was conducted for 12 months using the Medication Event Monitoring System. An alarming 86% of the participants were nonadherent with medications. Four clusters of medication taking and timing patterns were identified with evening doses presenting particular challenges. Depression, self-efficacy, social support, and medication side effects did not predict medication adherence. There was no significant difference in medication adherence scores between those with and without infections. Medication adherence pattern data from electronic monitoring provides an opportunity for health care professionals to move away from blaming the patient by attempting to identify predictors for medication nonadherence. Medication dose taking and timing patterns could be explored with patients so that medication adherence interventions could target specific patient patterns.
authors.affiliation: Sinclair School of Nursing, University of Missouri, Columbia, MO 65203, USA. RussellC@missouri.edu
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Russell
authors.forename: Muammer
authors.initials: M
authors.lastname: Cetingok
authors.forename: Karen Q
authors.initials: KQ
authors.lastname: Hamburger
authors.forename: Sarah
authors.initials: S
authors.lastname: Owens
authors.forename: Denise
authors.initials: D
authors.lastname: Thompson
authors.forename: Donna
authors.initials: D
authors.lastname: Hathaway
authors.forename: Rebecca P
authors.initials: RP
authors.lastname: Winsett
authors.forename: Vicki S
authors.initials: VS
authors.lastname: Conn
authors.forename: Richard
authors.initials: R
authors.lastname: Madsen
authors.forename: Lisa
authors.initials: L
authors.lastname: Sitler
authors.forename: Mark R
authors.initials: MR
authors.lastname: Wakefield
mesh_terms: D000368:Aged; D015400:Clinical Nursing Research; D016000:Cluster Analysis; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D004334:Drug Administration Schedule; D016903:Drug Monitoring / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000523:psychology* / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008838:Microcomputers; D008875:Middle Aged; D020377:Self Efficacy; D012944:Social Support; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013714:Tennessee
chemical_list: D007166:Immunosuppressive Agents