Abstract
Purpose
Our aim was to investigate the association between self-report measure and serum concentration
fluctuation of immunosuppressive medication (IM) in renal transplant recipients in
China and examine the relationship between post-transplantation time and IM adherence.
Methods
Renal transplant recipients at least 3 months post transplantation were recruited
from a follow-up outpatient clinic. Both self-reported Morisky Medication Adherence
Scale and serum concentration of IM (cyclosporine trough level and tacrolimus trough
level) were used to measure drug adherence.
Findings
Two hundred and nine patients were recruited in the study. The majority of the patients
received grafts from deceased donors (70.3%), were male (63.2%), and were married
(83.3%). The nonadherence to IM was 31.7%, as measured by the Morisky Medication Adherence
Scale. A statistically significant association between self-reported adherence and
serum concentration fluctuation of tacrolimus trough level was identified (P < 0.001), but not for cyclosporine (P = 0.997). Serum concentration fluctuation of tacrolimus trough levels and self-report
adherence of IM were associated with transplantation time (P < 0.001 and P = 0.003, respectively).
Implications
The Morisky Medication Adherence Scale appears valid in measuring drug adherence when
compared with serum concentration fluctuation. Both self-report questionnaire and
serum concentration fluctuation of tacrolimus changed with different post-transplantation
time. These 2 measurements could be integrated into routine clinical practice for
renal transplant recipients.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical TherapeuticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The burden of kidney disease: improving global outcomes.Kidney Int. 2004; 66: 1310-1314
- Prevalence of chronic kidney disease in the United States.JAMA. 2007; 298: 2038-2047
- Economic burden of chronic kidney disease.J Eval Clin Pract. 2008; 14: 422-434
- The cost-effectiveness of increasing kidney transplantation and home-based dialysis.Nephrology (Carlton). 2009; 14: 123-132
- Medication noncompliance and its implications in transplant recipients.Drugs. 2007; 67: 1463-1481
- Quantitative patterns of azathioprine adherence after renal transplantation.Transplantation. 2009; 87: 711-718
- Adherence to long-term therapies: evidence for action.WHO, Geneva2015
- The Take Control of Your Blood pressure (TCYB) study: study design and methodology.Contemp Clin Trials. 2007; 28: 33-47
- Prevalence and risk factors of non-adherence with immunosuppressive medication in kidney transplant patients.Am J Transplant. 2007; 7: 108-116
- Frequency and impact of nonadherence to immunosuppressants after renal transplantation: a systematic review.Transplantation. 2004; 77: 769-776
- Prevalence, consequences, and determinants of nonadherence in adult renal transplant patients: a literature review.Transpl Int. 2005; 18: 1121-1133
- Diagnostic accuracy of measurement methods to assess non-adherence to immunosuppressive drugs in kidney transplant recipients.Am J Transplant. 2008; 8: 616-626
- Evaluation of adherence to immunosuppressive drugs in kidney transplantation by control of medication dispensing.Transplant Proc. 2012; 44: 2391-2393
- Prevalence and correlates of medication non-adherence among kidney transplant recipients more than 6 months post-transplant: a cross-sectional study.BMC Nephrol. 2013; 14: 261
- Rates and risk factors for nonadherence to the medical regimen after adult solid organ transplantation.Transplantation. 2007; 83: 858-873
- Medicine non-adherence in kidney transplantation.J Ren Care. 2014; 40: 107-116
- Responses to a 1 month self-report on adherence to antiretroviral therapy are consistent with electronic data and virological treatment outcome.AIDS. 2002; 16: 269-277
- Medication adherence patterns in adult renal transplant recipients.Res Nurs Health. 2006; 29: 521-532
- Adherence and medical outcomes in pediatric liver transplant recipients who transition to adult services.Pediatr Transplant. 2007; 11: 608-614
- Measurement of compliance posttransplantation--the results of a 12-month study using electronic monitoring.Transplant Proc. 2003; 35: 796-797
- Medication adherence in chronic disease: issues in posttransplant immunosuppression.Transplant Proc. 2007; 39: 1287-1300
- Essentials You Need to Know after Kidney Transplantation.Central South University Press, Changsha, China2007
- Concurrent and predictive validity of a self-reported measure of medication adherence.Med Care. 1986; 24: 67-74
- The study on the compliance of patients with antihypertensive therapy and influence factors in community.Chin J Prev Cont Chron Dis. 2000; 8: 253-255
- Validity and reliability of the Morisky Questionnaire in assessing antihypertensive therapy compliance of hypertension patients in community.Chin J Hypertension. 2010; 18: 1067-1070
- The relationship between oral load and medicine adherence in renal transplant patients.Shandong Med J. 2013; 53: 87-88
- Present and future of immunosuppressive therapy in kidney transplantation.Transplant Proc. 2011; 43: 2439-2440
- Limited sampling strategy for the estimation of mycophenolic acid area under the concentration-time curve treated in Japanese living-related renal transplant recipients with concomitant extended-release tacrolimus.Biol Pharm Bull. 2013; 36: 1036-1039
- Optimal blood concentration of cyclosporine among Iranian kidney transplant recipients.Iran J Kidney Dis. 2012; 6: 373-379
Province, S.I.o.H., www.hntj.gov.cn/fxbg/2015fxbg/2015jmxx/201502/t20150226_115099.htm. 2015.
- Contemporary Organ Transplantation.Peopleʼs Medical Publishing House, Shelton, CT2011
- Gender disparity of living donor renal transplantation in East China.Clin Transplant. 2013; 27: 98-103
- The investment of adherence in renal transplantation.Chin J Nurs. 2005; 40: 19-21
- Correlation between medication compliance and health-related quality of life of kidney transplant recipient.J Nurs (China). 2015; 22: 33-37
- The effects of cognitive-behavior interventions on medication adherence in patients after kidney transplantation: a systematic review.J Nurs Admin. 2015; 15: 60-70
- Medication adherence in successful kidney transplant recipients.Prog Transplant. 2009; 19: 167-172
- Measuring compliance with drug regimens after renal transplantation: comparison of self-report and clinician rating with electronic monitoring.Transplantation. 2004; 77: 786-789
- The natural history of azathioprine compliance after renal transplantation.Kidney Int. 2001; 60: 1565-1570
- A switch from conventional twice-daily tacrolimus to once-daily extended-release tacrolimus in stable kidney transplant recipients.Transplant Proc. 2012; 44: 121-123
- Safety and efficacy of conversion from twice-daily tacrolimus (prograf) to once-daily prolonged-release tacrolimus (graceptor) in stable kidney transplant recipients.Transplant Proc. 2012; 44: 124-127
- Medication adherence in pediatric and adolescent liver transplant recipients.Pediatrics. 2004; 113: 825-832
- Drug utilization and compliance in patients with hypertension.China Health Care Nutr. 2013; 23: 56-58
Article info
Publication history
Published online: October 27, 2015
Accepted:
September 30,
2015
Identification
Copyright
© 2015 Elsevier HS Journals, Inc. Published by Elsevier Inc. All rights reserved.
