title: Factors associated with nonadherence to medication in kidney transplant recipients.
abstract: Nonadherence in kidney transplant recipients was evaluated in this report using a questionnaire with five binary questions and one question on a continuous scale. Study participants at the University of Utah Transplant Program (n = 199) were 43.0 ± 14.2 years old; 67% were males, and 81% were White. Two questions that produced heterogeneous outcome were analyzed: 'Do you ever forget to take your medication?' (79% no, 21% yes) and 'Have you ever taken your medications late?' (67% no, 33% yes). Responses to these questions correlated (χ² 65.2, p < 0.001; correlation coefficient 0.57, p < 0.001). We performed a logistic regression analysis to identify factors associated with the combined outcome of forgetting/not taking medications altogether or taking medications off schedule. Higher comorbidity index [odds ratio (OR) 2.19, p < 0.001], living (compared to deceased) donor (OR 2.81, p = 0.005) and full-time employment were associated with forgetting medications or taking them late (OR 3.12, p = 0.01). Recipient age tended to be associated with lower risk of nonadherence, but did not reach statistical significance (OR 0.98 per year of age, p = 0.13). Education level, smoking status, recipient race, dialysis modality, number of medications and the time since first kidney transplantation were not associated with the outcome. In conclusion, renal transplant recipients with greater comorbidity, receiving kidney from a living donor and with full-time employment reported lower levels of medication adherence.
authors.affiliation: Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass., USA. agoldfar@bidmc.harvard.edu
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Goldfarb-Rumyantzev
authors.forename: Seth
authors.initials: S
authors.lastname: Wright
authors.forename: Regina
authors.initials: R
authors.lastname: Ragasa
authors.forename: Doug
authors.initials: D
authors.lastname: Ostler
authors.forename: Jennifer
authors.initials: J
authors.lastname: Van Orden
authors.forename: Lonnie
authors.initials: L
authors.lastname: Smith
authors.forename: Ekaterina
authors.initials: E
authors.lastname: Efimova
authors.forename: Lyska
authors.initials: L
authors.lastname: Emerson
authors.forename: Gurprataap Singh
authors.initials: GS
authors.lastname: Sandhu
authors.forename: Fuad
authors.initials: F
authors.lastname: Shihab
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D015897:Comorbidity; D004651:Employment; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy / Q000517:prevention & control*; D006801:Humans; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation; D019520:Living Donors; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires