title: Adherence to immunosuppression in adult lung transplant recipients: prevalence and risk factors.
abstract: BACKGROUND
  Adherence to medication is a favourable with regard to survival after kidney, heart and liver transplantation. Little is known about adherence to medication in lung transplant recipients. To determine the prevalence of adherence and identify risk factors of non-adherence (NA) we evaluated adherence to tacrolimus in adult lung transplant recipients who were at least 1 year after transplantation.
  
  
  METHODS
  Tacrolimus intake was prospectively monitored using the Medication Event Monitoring System (MEMS). Recipients qualified as adherent if a timing-adherence score of ≥ 80% was reached. Patients' characteristics and possible risk factors for NA were collected using the Karnofsky Performance Index, Self-Care Agency ASA Scale, State-Trait Anxiety Inventory, Zung Self-Rating Depression Scale, and the Long-Term Medication Behavior Self-Efficacy Scale.
  
  
  RESULTS
  Ninety-one recipients used MEMS for a median of 95 days (range 50 to 124 days) and were included. They showed a median timing-adherence score of 98.1% (range 31.2% to 100%). A timing-adherence score of ≥ 80% was seen in 92.3% of the recipients. Multiple logistic regression showed an association of lower timing-adherence scores with younger age and lower ability of self-care.
  
  
  CONCLUSIONS
  Adherence to immunosuppressive therapy was very high in lung transplant recipients. Only 7.7% of the recipients were non-adherent. Younger recipients and recipients with lower ability of self-care appeared to be at risk for NA. Follow-up of clinical data is needed to determine whether NA is associated with poorer outcome, specifically bronchiolitis obliterans syndrome.
authors: Department of Pulmonary Diseases, University Medical Centre Groningen, Groningen, The Netherlands. o.h.bosma@long.umcg.nl
authors: Otto H
authors: OH
authors: Bosma
authors: Karin M
authors: KM
authors: Vermeulen
authors: Erik A
authors: EA
authors: Verschuuren
authors: Michiel E
authors: ME
authors: Erasmus
authors: Wim
authors: W
authors: van der Bij
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001989:Bronchiolitis Obliterans / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010349:Patient Compliance; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents