Nonadherence Behaviors and Some Related Factors in Kidney Transplant Recipients

Pari Hedayati, Nahid Shahgholian, Ahmad Ghadami, Pari Hedayati, Nahid Shahgholian, Ahmad Ghadami

Abstract

Background: Kidney transplantation is the renal replacement therapy of choice for most patients with end-stage renal disease (ESRD), however, adherence to the recommended lifestyle is critical for a positive prognosis. The purpose of this study was to assess adherence to immunosuppressive therapy and lifestyle recommendations along with some related factors among kidney transplant patients.

Materials and methods: In this descriptive analytical study, all patients completed a questionnaire regarding medication intake and lifestyle recommendations (preventing of infection, self-monitoring, prevention of cardiovascular disease (CVD), and sun protection). The participants were divided into 4 groups according to the level of adherence (good, partial, poor, and nonadherent) indicated in their responses.

Results: Most kidney recipients were adherent to their drug prescriptions, but were partial, poor, or nonadherent regarding lifestyle recommendations. Increased passage of time since transplantation and low family support and educational level resulted in nonadherence. Men showed greater adherence to medication intake than women. Patients with lower number of drugs and reported drug side-effects illustrated better adherence to medication intake. Women adhered to infection protection recommendations more than men, and older and married patients adhered to cardiovascular prevention recommendations more than others. However, younger patients showed greater adherence to self-monitoring recommendations, and singles, young individuals, and women were adherent to sun protection recommendations.

Conclusions: Nonadherence is common among kidney transplant recipients. Thus, it is necessary to determine patients who are at risk of nonadherence and to introduce more educational programs to improve their adherence and their quality of life (QOL).

Keywords: Adherence; Iran; Kidney transplantation nursing.

Conflict of interest statement

There are no conflicts of interest.

References

    1. Namdar A, Beigizadeh SH, Najafipour S. Health-related quality of life in dialysis patients. J Jahrom Univ Med Sci. 2013;10:16–24.
    1. Tayyebi A, Raiesifar A, Najafi Mehri S, Ebadi A, Einolahi B, Pashandi SH. Measuring Health Related Quality of Life (Hrqol) in Renal Transplant Patients: Psychometric Properties and Cross-Cultural Adaptation of Kidney Transplant Questionnaire (Ktq-25) in Persian. Nephrourol Mon. 2012;4:617–21.
    1. Tabatabai SA, Hashemi SM, Zandi M. Frequency distribution of long time complications of renal transplantation in Alzahra hospital. J Isfahan Med School. 2011;28:1–10.
    1. Germani G, Lazzaro S, Gnoato F, Senzolo M, Borella V, Rupolo G, et al. Nonadherent behaviors after solid organ transplantation. Transplant proc. 2011;43:318–23.
    1. Green M. Introduction: Infections in solid organ transplantation. Am J Transplant. 2013;13:3–8.
    1. Shirali AC, Bia MJ. Management of cardiovascular disease in renal transplant recipients. Clin J Am Soc Nephrol. 2008;3:491–504.
    1. Diao DY, Lee TK. Sun-protective behaviors in populations at high risk for skin cancer. Psychol Res Behav Manag. 2013;7:9–18.
    1. Marsicano Ede O, Fernandes Nda S, Colugnati F, Grincenkov Frd S, Fernandes NM, De Geest S, et al. Transcultural adaptation and initial validation of Brazilian-Portuguese version of the Basel assessment of adherence to immunosuppressive medications scale (BAASIS) in kidney transplants. BMC Nephrol. 2013;14:108.
    1. Shellmer DA, Dabbs AD, Dew MA. Medical adherence in pediatric organ transplantation: What are the next steps? Curr Opin Organ Transplant. 2011;16:509–14.
    1. Lennerling A, Forsberg A. Self-reported non-adherence and beliefs about medication in a Swedish kidney transplant population. Open Nurs J. 2012;6:41–6.
    1. Giardini A, Pierobon A, Majani G, Biffa G, Volpe B, Sala A, et al. Adherence self report assessment in solid-organ pre and post transplant recipients. G Ital Med Lav Ergon. 2011;33:69–76.
    1. Williams A.F, Manias E, Gaskin C.J, Crawford K. Medicine non-adherence in kidney transplantation. J Ren Care. 2014;40:107–16.
    1. Kobus G, Małyszko J, Małyszko JS, Puza E, Bachórzewska-Gajewska H, Mysliwiec M. Compliance with lifestyle recommendations in kidney allograft recipients. Transplant proc. 2011;43:2930–4.
    1. Gheith OA, El-Saadany SA, Abuo Donia SA, Salem YM. Compliance with recommended life style behaviors in kidney transplant recipients: Does it matter in living donor kidney transplant? Iran J Kidney Dis. 2008;2:218–26.
    1. Prendergast M.B, Gaston R.S. Optimizing Medication Adherence: An Ongoing Opportunity To Improve Outcomes After Kidney Transplantation Transplantation. Clin J Am Soc Nephrol. 2010;5:1305–11.
    1. Blanca Martínez Pérez A, LÓpez Suárez A, Rodríguez Rodríguez J, Sobrino Márquez J.M, Lage Gallé E. Medication Adherence in Patients Who Undergo Cardiac Transplantation. Transplant proc. 2013;45:2662–4.
    1. McCune KR. Nonadherence to Immunosuppressive Medication: New Insights. Immunology. 2013;10:22–5.
    1. Prihodova L, Nagyova I, Rosenberger J, Majernikova M, Roland R, Groothoff JW, et al. Adherence in patients in the first year after kidney transplantation and its impact on graft loss and mortality: A cross-sectional and prospective study. J Adv Nurs. 2014;70:2871–83.
    1. Shabany Hamedan M, Mohammad Aliha J, SHekarabi R, Hosseini AF. Relationship between adherence to medication regimen and quality of life in renal transplant patients. Iran J Nurs. 2010;23:29–34.
    1. Kugler C, Geyer S, Gottlieb J, Simon A, Haverich A, Dracup K. Symptom experience after solid organ transplantation. J Psychosom Res. 2009;66:101–10.
    1. Denhaerynck K, Dobbels F, Cleemput I, Desmyttere A, Schafer-Keller P, Schaub P, et al. Prevalence, consequences, and determinants of nonadherence in adult renal transplant patients. Transpl Int. 2005:1121–33.
    1. Morales JM, Varo E, Lazaro P. Immunosuppressant treatment adherence, barriers to adherence and quality of life in renal and liver transplant recipients in Spain. Clin Transplant. 2012;26:369–76.
    1. Urstad KH. Doctoral Thesis, Faculty of Medicine. Norway: University of Oslo; 2013. Patient Education for Renal Transplant Recipients.
    1. Dew MA, DiMartini AF, De Vito Dabbs A, Myaskovsky L, Steel J, Unruh M, et al. Rates and risk factors for nonadherence to the medical regimen after adult solid organ transplantation. Transplantation. 2007;83:858–73.
    1. Nourbala MH, Nemati E, Rostami Z, Einollahi B. Impact of cigarette smoking on kidney transplant recipients: A systematic review. Iran J Kidney Dis. 2011;5:141–8.
    1. Firooz A, Amin-Nejad R, Bouzari N, Nafar M, Firoozan A, Mahdavi-Mazdeh M. Sun protection in Iranian kidney transplant recipients: Knowledge, attitude and practice. J Eur Acad Dermatol Venereol. 2007;21:754–7.
    1. Ulrich C, Jürgensen J.S, Degen A, Hackethal M, Ulrich M, Patel M.J, et al. Prevention of non-melanoma skin cancer in organ transplant patients by regular use of a sunscreen: A 24 months, prospective, case–control study. Br J Dermatol. 2009;161:78–84.
    1. Clowers-Webb HE, Christenson LJ, Phillips PK, Roenigh RK, Nguyen TH, Weavwe AL, et al. Educational outcomes regarding skin cancer in organ transplant recipients: Randomized intervention of intensive vs. standard education. Arch Dermatol. 2006;142:712–8.
    1. Massey EK, Tielen M, Laging M, Beck DK, Khemai R, van Gelder T, et al. The role of goal cognitions, illness perceptions and treatment beliefs in self-reported adherence after kidney transplantation: A cohort study. J Psychosom Res. 2013:229–34.

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