title: Effects of switching from twice-daily to once-daily tacrolimus formulation on quality of life, anxiety, and transplant benefit perception after kidney transplantation.
abstract: OBJECTIVE
  This study investigated whether switching from the twice-daily (Prograf; TAC) to the once-daily formulation of tacrolimus with extended release (Advagraf; XL) affected quality of life, anxiety, and transplant benefit perception after allogeneic kidney transplantation.
  
  
  METHODS
  After local Institutional Review Board approval, 78 adult patients prescribed twice-daily tacrolimus for ≥1 year after kidney transplantation were asked to participate in this study. All patients were evaluated at T0 (before the switch), and the 49 who accepted the change were reassessed after 6 months (T1). The following tests were used: (State and Trait Anxiety Inventories Y1 and Y2, (Psychologic General Well-Being Index), and modified Transplant Effect Questionnaire for posttransplantation symptoms. Blood samples for laboratory profiles and determinations of drug concentrations were obtained throughout the study period.
  
  
  RESULTS
  There were no significant differences between the psychologic variables at T0 among patients who switched from TAC to XL (n=49) versus those who did not participate (n=29). Eight of the 49 patients who accepted the drug conversion were reswitched to TAC because of adverse events. At T1, the remaining switched patients (n=41) showed an increase in the disclosure of having undergone transplantation (P<.05) versus nonswitched patients; whereas reswitched patients (n=8) showed less positivity and well-being (P<.05) compared with those who remained in the switched regimen.
  
  
  CONCLUSIONS
  The findings suggested increased disclosure of having undergone transplantation among patients who decided to switch from TAC to XL.
authors.affiliation: Department of Psychiatry and Psychology, Sapienza University of Rome, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Calia
authors.forename: C
authors.initials: C
authors.lastname: Lai
authors.forename: P
authors.initials: P
authors.lastname: Aceto
authors.forename: M
authors.initials: M
authors.lastname: Luciani
authors.forename: J
authors.initials: J
authors.lastname: Romagnoli
authors.forename: S
authors.initials: S
authors.lastname: Lai
authors.forename: A
authors.initials: A
authors.lastname: Gargiulo
authors.forename: F
authors.initials: F
authors.lastname: Citterio
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001007:Anxiety / Q000209:etiology*; D003692:Delayed-Action Preparations; D004334:Drug Administration Schedule; D016903:Drug Monitoring; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D007558:Italy; D016030:Kidney Transplantation / Q000276:immunology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010465:Perception; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016559:Tacrolimus / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome; D014342:Truth Disclosure
chemical_list: D003692:Delayed-Action Preparations; D007166:Immunosuppressive Agents; D016559:Tacrolimus