title: The perspectives of kidney transplant recipients on medicine taking: a systematic review of qualitative studies.
abstract: BACKGROUND
  Non-adherence to medication regimens after kidney transplantation is a major risk factor for acute rejection and graft loss, yet little is known about the perspectives of kidney transplant recipients on medicine taking. This study aimed to describe the beliefs, experiences and perspectives of kidney transplant recipients on medicine taking.
  
  
  METHODS
  We conducted a systematic review of qualitative studies of medicine taking after kidney transplantation. Five electronic databases (to Week 3 of January 2010) were searched. Thematic synthesis of the results and conclusions reported in each included study was performed to develop descriptive and analytical themes.
  
  
  RESULTS
  We included seven studies involving 207 participants. The six themes identified were (i) attitudes towards medicine taking, its impact on lifestyle, self-image, relationships and outlook on life; (ii) inadvertent forgetfulness, preoccupation with life commitments; (iii) medication properties; (iv) structure of healthcare services, poor access to pharmacy or affordable medications and conflicting medical appointments; (v) personal efforts in managing medications, organizing and devising strategies for taking medicines on time; and (vi) availability of external social support. These underpinned five reported medicine-taking behaviours including not taking medicines, seeking to change medications or dose, missing a dose, varying the timing of doses and vigilant adherence.
  
  
  CONCLUSIONS
  Considering patients' attitudes, priorities, current life events, commitments, support systems and healthcare structures can inform interventions to promote concordance between prescribed medication and medicine-taking behaviours. This may improve treatment outcomes and mitigate the risks of non-adherence-related rejection.
authors.affiliation: Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia. AllisonT@health.usyd.edu.au
authors.forename: Allison
authors.initials: A
authors.lastname: Tong
authors.forename: Martin
authors.initials: M
authors.lastname: Howell
authors.forename: Germaine
authors.initials: G
authors.lastname: Wong
authors.forename: Angela C
authors.initials: AC
authors.lastname: Webster
authors.forename: Kirsten
authors.initials: K
authors.lastname: Howard
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Craig
mesh_terms: D006801:Humans; D058186:Acute Kidney Injury / Q000628:therapy; D006084:Graft Rejection / Q000188:drug therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation; D055118:Medication Adherence; D010349:Patient Compliance; D036301:Qualitative Research; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents