title: Low Adherence to Immunosuppressants Is Associated With Symptom Experience Among Kidney Transplant Recipients.
abstract: OBJECTIVE
  The purpose of this study was to investigate the relationship between immunosuppressant-related symptom experience (SE) and adherence to immunosuppressant regimens among kidney transplant (KT) recipients.
  
  
  METHODS
  A total of 239 KT recipients on an immunosuppressant regimen who were followed up after transplantation participated in this study. Data was collected through a self-reported questionnaire survey (medication adherence, SE, and quality of life) and medical record review.
  
  
  RESULTS
  Low adherence in the immunosuppressant group was associated with longer time since KT, less comorbidity (<3), and a higher rehospitalization rate. Low adherence among KT recipients showed significantly greater overall symptom occurrence (P = .001) and symptom distress (P = .002) levels than patients with high or medium adherence after adjusting for a number of covariates. The most common symptom both in terms of occurrence (96.4%) and distress (91.1%) among poorly adherent KT recipients was tiredness.
  
  
  CONCLUSIONS
  Low adherence to an immunosuppressant regimen was significantly associated with high SE among KT recipients. Strategies to decrease immunosuppressant-related SE are needed to improve adherence to immunosuppressants.
authors.affiliation: Department of Adult Clinical Nursing, The Graduate School of Nursing, Yonsei University, Seoul, Korea; Department of Transplantation Surgery, Severance Hospital, Yonsei University Health System, Seoul, Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Clinical Nursing Science, Nursing Policy Research Institute, Yonsei University College of Nursing, Seoul, Korea. Electronic address: shchu@yuhs.ac.
authors.forename: S H
authors.initials: SH
authors.lastname: Chu
authors.affiliation: Department of Clinical Nursing Science, Nursing Policy Research Institute, Yonsei University College of Nursing, Seoul, Korea.
authors.forename: E G
authors.initials: EG
authors.lastname: Oh
authors.affiliation: Department of Transplantation Surgery, Severance Hospital, Yonsei University Health System, Seoul, Korea.
authors.forename: K H
authors.initials: KH
authors.lastname: Huh
mesh_terms: D000328:Adult; D005221:Fatigue / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control / Q000523:psychology*; D011788:Quality of Life; D057566:Self Report; D013997:Time Factors; D066027:Transplant Recipients / Q000523:psychology*; D016903:Drug Monitoring
chemical_list: D007166:Immunosuppressive Agents