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Immunosuppressant Nonadherence in Heart, Liver, and Lung Transplant Patients: Associations With Medication Beliefs and Illness Perceptions.
MedLine Citation:
PMID:  22343337     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Nonadherence to immunosuppressant medication is a significant problem among solid organ transplant recipients. Previous research suggests that patients' perceptions about their medications may be a better predictor of nonadherence than demographic factors. This study aimed to further investigate the role of patients' perceptions about their transplant and medication beliefs in nonadherence. METHODS: This was a cross-sectional observational study. Participants were 87 heart, 46 lung, and 193 liver transplant patients. All surviving heart, lung, and liver transplant patients from Auckland City Hospital and Greenlane Hospital older than 16 years who had received their transplant at least 3 months before study commencement were mailed questionnaires. Standardized self-report measures were used to assess illness perceptions, medication beliefs, and adherence. RESULTS: Nonadherent patients had lower perceptions about the necessity of medication, weaker beliefs that medication could prevent rejection, and higher concerns about its harms, than adherers. Nonadherers perceived that their transplant and immunosuppressant medication caused more symptoms and were more distressed about symptoms than adherers; they understood their transplant less, perceived their transplant had a larger impact on their lives, affected them more emotionally, and caused greater concern, than patients who were more adherent. A regression model that included these perceptions and demographic variables correctly classified 71% of patients as adherent or nonadherent. CONCLUSIONS: The perceptions that patients hold about their transplant and medications are associated with adherence to immunosuppressant medications. Future research could investigate whether a psychologic intervention could change patients' perceptions to improve adherence.
Authors:
Mary Kung; Heidi E Koschwanez; Liz Painter; Val Honeyman; Elizabeth Broadbent
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-17
Journal Detail:
Title:  Transplantation     Volume:  -     ISSN:  1534-6080     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1 Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand. 2 Heart and Lung Transplant Service, Auckland District Health Board, Auckland City Hospital, Auckland, New Zealand. 3 Liver Transplant Service, Auckland District Health Board, Auckland City Hospital, Auckland, New Zealand.
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