Immunosuppressive medication adherence in kidney transplant patients

ABSTRACT

To assess the degree of immunosuppressive medication adherence in kidney transplant patients [KTPs] and to determine if there is a difference in the rate of adherence to tacrolimus [Tac], cyclosporine [CsA] and sirolimus [Sir]. From a total of 63 KTPs treated at the Clinic of Nephrology, Clinical Centre Nis, Serbia, 60 participated in the study by responding to questionnaires. They were divided into the adherence group [n = 43] and the nonadherence group [n = 17] according to their degree of adherence which was measured using a validated survey form, the simplified medication adherence questionnaire. The KTP adherence to the different immunosuppressive regimens [Tac, CsA and Sir] was compared. Statistical analysis was performed using the Student t test. Adherence was observed in 43 [71.7%] patients, and only 17 [28.3%] did not follow the prescribed therapy. The estimated glomerular filtration rate was significantly lower in the nonadherence group [38.52 +/- 18.22 ml/min] than in the adherence group [52.43 +/- 16.91 ml/min, p < 0.05]. With regard to the Tac level, a significant difference was also found between the adherers and the nonadherers [6.30 +/- 2.06 vs. 5.0 +/- 1.52 ng/ml, p < 0.05]. The KTPs in this study demonstrated a high level of adherence. Nonadherence was associated with worse graft function and a lower Tac level. Knowledge about the degree of adherence could help the early identification of nonadherent patients and the development of strategies to improve this