Satisfaction and adherence with immunosuppressant treatment in renal transplant patients living with a working graft.
BACKGROUND
The aim of this study was to analyze patient satisfaction and adherence in a sample of renal transplant patients living with a working allograft.


METHODS
An epidemiological cross-sectional multicenter study was carried out with renal recipients who had received a transplant 6-24 months before and were undergoing immunosuppressant therapy (IT). Sociodemographic and clinical variables registered were dosage, allograft functioning, number of medications, health-related quality of life (HRQoL by SF-6D), patients' satisfaction (SAT-Q) and adherence to medication (abnormal levels of immunosuppressant in blood tests [ALIBT] and clinical impression). Relationships between those parameters were contrasted (chi-square test, Spearman correlation coefficient and Mann-Whitney U-test). Multivariate regression models (linear and logistic) were computed to analyze the factors related to patients' satisfaction and adherence to medication, respectively.


RESULTS
Data from 206 patients were collected (61.2% males with a mean age of 53.35 years). Nonadherence rates (29.1% and 31.1%) were found according to clinical impression and ALIBT, respectively (chi-square = 31.810, p<0.001). Overall, global patients' satisfaction (74.000 ± 1.251) and HRQoL (0.765 ± 0.011) levels were high. Low-moderate significant associations between satisfaction and adherence to IT and HRQoL were found (p<0.01). Finally, age, vitality, allograft functioning and dosage were correlated with patient satisfaction (R2=0.174; F(1,185)=4.134; p<0.043). Number of medications (odds ratio [OR] = 0.890; 95% confidence interval [95% CI], 0.812-0.975; p=0.012), convenience domain (OR=1.037; 95% CI, 1.005-1.070; p=0.021) and clinical criteria (OR=6.135; 95% CI, 2.945-12.782; p<0.001) were associated with adherence.


CONCLUSIONS
In renal transplant patients, satisfaction with IT is related to the levels of HRQoL and compliance.
Department of Nephrology, Hospital Central Universitario de Asturias, Oviedo, Spain.
Francisco
F
Ortega
Alejandra
A
Otero
José F
JF
Crespo
Juan F
JF
Delgado
José M
JM
Borro
Jesús
J
Cuervo
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D016903:Drug Monitoring; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D017060:Patient Satisfaction; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D007166:Immunosuppressive Agents