title: A New Quantitative Approach to Assessing Noncompliance With Medical Recommendations in Heart Transplant Recipients.
abstract: BACKGROUND
  Failure of compliance with medical regimen is one of the major risk factors associated with morbidity and mortality in heart transplant (HT) recipients. Nevertheless, to date, there is no specific, gold-standard, comprehensive set of tools for assessing compliance in these patients.
  
  
  OBJECTIVE
  The objective of the present study was to develop a specific instrument for the assessment of noncompliance with medical recommendations in HT recipients.
  
  
  METHODS
  This prospective observational study used a nonprobability sampling method, which was performed from January 2006 to December 2012. All of the patients met clinical criteria for being included on the waiting list for a HT. We designed a scale for measuring the compliance degree at 12 months after heart transplantation. This scale included the most important aspects of the medical regimen, using nine discrete quantitative variables. The total score was described as the patient's Noncompliance Factor (NCF). The results were analysed by mean, ranks, and percentages.
  
  
  RESULTS
  The sample was constituted of 61 participants who underwent surgical HT intervention and completed the 12-month follow-up assessment. The overall incidence of noncompliance was around 30% and only 43.1% of the recipients had an acceptable degree of compliance.
  
  
  CONCLUSIONS
  The overall incidence of noncompliance in HT recipients is high and this can generate worse clinical outcomes. Evaluation by specific screening instruments like the one proposed in the present study can be useful for a systematic detection of this phenomenon.
authors: Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain. Electronic address: 39639rsg@gmail.com.
authors: R
authors: R
authors: Sánchez
authors: Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain.
authors: E
authors: E
authors: Baillès
authors: Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain.
authors: A
authors: A
authors: Bastidas
authors: Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain.
authors: L
authors: L
authors: Serrano
authors: Department of Cardiology, Heart Transplantation Division, Instituto Clínico del Tórax, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain.
authors: F
authors: F
authors: Pérez-Villa
authors: Department of Cardiology, Heart Transplantation Division, Instituto Clínico del Tórax, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain.
authors: M Á
authors: MÁ
authors: Castel
authors: Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain.
authors: L
authors: L
authors: Pintor
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000523:psychology*; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011184:Postoperative Period; D011446:Prospective Studies; D012307:Risk Factors; D012494:Sampling Studies; D014850:Waiting Lists