Evaluation of Adherence to Immunosuppressive Drugs in Kidney Transplantation by Control of Medication Dispensing

• Published in: Transplantation proceedings Vol. 44; no. 8; pp. 2391 - 2393
• Main Authors: Brahm, M.M.T, Manfro, R.C, Mello, D, Cioato, S, Gonçalves, L.F.S
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 01-10-2012; Elsevier
• Subjects: Adult; Age Factors; Biological and medical sciences; Brazil; Cross-Sectional Studies; Employment; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Glomerular Filtration Rate - drug effects; Graft Rejection - immunology; Graft Rejection - physiopathology; Graft Rejection - prevention & control; Graft Survival - drug effects; Humans; Immunosuppressive Agents - therapeutic use; Kidney Transplantation - immunology; Linear Models; Male; Medical sciences; Medication Adherence; Middle Aged; Multivariate Analysis; Registries; Risk Assessment; Risk Factors; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Time Factors; Tissue, organ and graft immunology; Treatment Outcome; Brazil; Drug; Evaluation; Compliance; Check; Homotransplantation; Kidney; Medicine; Chemotherapy; Treatment; Urinary system; Surveillance; Surgery; Graft; Immunosuppressive agent; Kidney transplantation
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2012.08.001

Abstract Nonadherence to immunosuppressive medications represents a burden to organ transplantation being associated with rejection episodes and graft loss. In this cross-sectional study we evaluated the prevalence and risk factors for nonadherence in kidney transplant patients by measuring the retrieval of the immunosuppressive drugs in the registry kept by the state Rio Grande do Sul public health system. We considered nonadherence the failure to retrieval of medication at least one time over a 1-year period of evaluation. In 288 patients evaluated, the frequency of failure to retrieve was 58.7%. Being fully employed (66.4% × 33.6%, P = .008) and younger age at transplantation (39 ± 13 × 46 ± 11, P = .011) were associated with nonadherence. Multivariate analysis showed a greater prevalence ratio (PR) of non- adherence in patients using tacrolimus. Estimated glomerular filtration rate was significantly lower in the nonadherence groups as compared with adherent groups (45.3 ± 21.6 × 51.3 ± 19.4, P = .016). In conclusion, we found a high prevalence of nonadherence to immunosuppressive drugs with association to active working situation and use of tacrolimus. Importantly, glomerular filtration rate was found to be lower in nonadherent patients.