title: Influence of intention to adhere, beliefs and satisfaction about medicines on adherence in solid organ transplant recipients.
abstract: BACKGROUND
  Nonadherence to immunosuppressive (IS) therapy is associated with poor outcomes. Identifying factors predicting poor adherence is therefore essential. The primary objective of this study was to test whether parameters of a model adapted from the theory of planned behavior, and more specifically attitudes that are influenced by beliefs and satisfaction with medication, could predict adherence in solid organ transplant patients.
  
  
  METHODS
  Adherence was assessed with a self-reported medication adherence scale and IS blood trough concentrations over 6 months, in four transplant units. Satisfaction and beliefs were assessed using the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) and Beliefs about Medicines Questionnaire (BMQ), respectively. Theory of planned behavior was assessed with a specific questionnaire exploring intentions, subjective norms, attitudes and perceived behavioral control. Treatment characteristics and socioeconomic data were also collected.
  
  
  RESULTS
  One hundred and fifty-three solid organ transplant patients were enrolled, including lung (n=33), heart (n=43), liver (n=42), and kidney (n=44) patients. Satisfaction and positive beliefs about medication were higher in adherent than those in nonadherent patients. Factors independently associated with an increased risk of nonadherence were negative general beliefs about medications (odds ratio [OR]=0.89 [0.83-0.97]), living alone (OR=2.78 [1.09-7.09]), heart transplantation (OR=3.49 [1.34-9.09]), and being on everolimus (OR=5.02 [1.21-20.8]).
  
  
  CONCLUSIONS
  Negative beliefs toward medications were shown to be an independent risk factor of poor adherence. Therefore, the BMQ could be an effective, easy to implement tool, for use in everyday practice, to identify patients needing interventions to improve adherence to IS.
authors.affiliation: 1 Pharmacy Department, Grenoble University Hospital, Grenoble, France. 2 University Grenoble-Alpes, Grenoble, France. 3 Clinical Research Center, Inserm CIC1406, Grenoble University Hospital, Grenoble, France. 4 TIMC-IMAG UMR 5525/ThEMAS, Grenoble, France. 5 Pneumology Department, Grenoble University Hospital, Grenoble, France. 6 Cardiology Department, Grenoble University Hospital, Grenoble, France. 7 Hepatogastroenterology Department, Grenoble University Hospital, Grenoble, France. 8 Nephrology Department, Grenoble University Hospital, Grenoble, France. 9 Laboratory of Educational Sciences, Grenoble, France. 10 Address correspondence to: Benoît Allenet, Pharm.D., Pôle Pharmacie, CHU de Grenoble, 38043 Grenoble Cedex 09, France.
authors.forename: Amélie
authors.initials: A
authors.lastname: Hugon
authors.forename: Matthieu
authors.initials: M
authors.lastname: Roustit
authors.forename: Audrey
authors.initials: A
authors.lastname: Lehmann
authors.forename: Christel
authors.initials: C
authors.lastname: Saint-Raymond
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Borrel
authors.forename: Marie-Noëlle
authors.initials: MN
authors.lastname: Hilleret
authors.forename: Paolo
authors.initials: P
authors.lastname: Malvezzi
authors.forename: Pierrick
authors.initials: P
authors.lastname: Bedouch
authors.forename: Pascal
authors.initials: P
authors.lastname: Pansu
authors.forename: Benoît
authors.initials: B
authors.lastname: Allenet
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003469:Culture; D016903:Drug Monitoring; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D033182:Intention; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016377:Organ Transplantation / Q000009:adverse effects; D017060:Patient Satisfaction; D010465:Perception; D012307:Risk Factors; D057566:Self Report; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents