title: Factors that determine self-reported immunosuppressant adherence in kidney transplant recipients: a correlational study.
abstract: OBJECTIVE
  To determine the factors related to immunosuppressant therapy adherence in kidney transplant recipients in Taiwan.
  
  
  BACKGROUND
  Adherence to immunosuppressant treatment is critical after kidney transplantation. Thus, the factors associated with self-reported medication adherence in kidney transplant recipients warrant investigation.
  
  
  METHODS
  The study used a cross-sectional and correlation design.
  
  
  METHODS
  A convenience sample of 145 kidney transplant recipients was included. Structured questionnaires were used to collect data during 2012-2013. Multivariate linear regression was used to examine the factors related to immunosuppressant therapy adherence.
  
  
  RESULTS
  Over half of the participants were female (54·5%), mean age was 45·5 years, and mean year after transplant was 7·4. The mean score for medication adherence was 29·73 (possible score range 7-35). The results of the multivariate linear regression analysis showed that gender (male), low income with a high school or college education, years after transplantation and concerns about medication taking were negatively associated with adherence. Medication self-efficacy was positively associated with adherence. Therapy-related factors, partnerships with healthcare professionals and having private healthcare insurance did not significantly relate to immunosuppressant therapy adherence.
  
  
  CONCLUSIONS
  Kidney transplant recipients demonstrated a high level of adherence. Strategies to enhance patients' self-efficacy and alleviate concerns about medication may promote medication adherence. Male patients, those with a lower income and those with a higher education level, should be a focus of efforts to maintain adherence to the medication regimen.
authors.affiliation: School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Department of General Surgery, Chang Gung Medical Foundation-Linkuo, Taoyuan, Taiwan.
authors.forename: Li-Chueh
authors.identifier: http://orcid.org/0000-0002-6926-988X
authors.initials: LC
authors.lastname: Weng
authors.affiliation: School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Ya-Chen
authors.initials: YC
authors.lastname: Yang
authors.affiliation: School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Department of Neurology, Chang Gung Medical Foundation-Linkuo, Taoyuan, Taiwan.
authors.forename: Hsiu-Li
authors.initials: HL
authors.lastname: Huang
authors.affiliation: Transplantation Center and Urology Surgery, Chang Gung Medical Foundation-Linkuo Medical Center, Taoyuan, Taiwan.
authors.forename: Yang-Jen
authors.initials: YJ
authors.lastname: Chiang
authors.affiliation: School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Yu-Hsia
authors.initials: YH
authors.lastname: Tsai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000078331:Correlation of Data; D003430:Cross-Sectional Studies; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000523:psychology*; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D057566:Self Report; D013624:Taiwan; D066027:Transplant Recipients / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D007166:Immunosuppressive Agents
keywords: health care; immunosuppressant; kidney transplantation; medication adherence; medication belief; non-adherence; nursing; partnership; self-efficacy; symptom distress