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Adherence to immunosuppression in adult lung transplant recipients: Prevalence and risk factors.
MedLine Citation:
PMID:  21724418     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Adherence to medication is a favourable with regard to survival after kidney, heart and liver transplantation. Little is known about adherence to medication in lung transplant recipients. To determine the prevalence of adherence and identify risk factors of non-adherence (NA) we evaluated adherence to tacrolimus in adult lung transplant recipients who were at least 1 year after transplantation. METHODS: Tacrolimus intake was prospectively monitored using the Medication Event Monitoring System (MEMS). Recipients qualified as adherent if a timing-adherence score of ≥80% was reached. Patients' characteristics and possible risk factors for NA were collected using the Karnofsky Performance Index, Self-Care Agency ASA Scale, State-Trait Anxiety Inventory, Zung Self-Rating Depression Scale, and the Long-Term Medication Behavior Self-Efficacy Scale. RESULTS: Ninety-one recipients used MEMS for a median of 95 days (range 50 to 124 days) and were included. They showed a median timing-adherence score of 98.1% (range 31.2% to 100%). A timing-adherence score of ≥80% was seen in 92.3% of the recipients. Multiple logistic regression showed an association of lower timing-adherence scores with younger age and lower ability of self-care. CONCLUSIONS: Adherence to immunosuppressive therapy was very high in lung transplant recipients. Only 7.7% of the recipients were non-adherent. Younger recipients and recipients with lower ability of self-care appeared to be at risk for NA. Follow-up of clinical data is needed to determine whether NA is associated with poorer outcome, specifically bronchiolitis obliterans syndrome.
Authors:
Otto H Bosma; Karin M Vermeulen; Erik A Verschuuren; Michiel E Erasmus; Wim van der Bij
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-1
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  -     ISSN:  1557-3117     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Pulmonary Diseases, University Medical Centre Groningen, Groningen, The Netherlands.
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