Medication Adherence in Older Renal Transplant Recipients

Abstract

This project examined patterns, predictors, and outcomes of medication adherence in a convenience sample of 37 renal transplant recipients aged 55 years or older in a Mid-Southern U.S. facility using an exploratory, descriptive, longitudinal design. Electronic monitoring was conducted for 12 months using the Medication Event Monitoring System. An alarming 86% of the participants were nonadherent with medications. Four clusters of medication taking and timing patterns were identified with evening doses presenting particular challenges. Depression, self-efficacy, social support, and medication side effects did not predict medication adherence. There was no significant difference in medication adherence scores between those with and without infections. Medication adherence pattern data from electronic monitoring provides an opportunity for health care professionals to move away from blaming the patient by attempting to identify predictors for medication nonadherence. Medication dose taking and timing patterns could be explored with patients so that medication adherence interventions could target specific patient patterns.

Predicting intentions and adherence behavior in the context of organ transplantation: Gender differences of provided social support

“…Self-efficacy, however, was neither associated to intentions nor to adherence behavior directly. The lack of an effect of self-efficacy has also been reported in other studies in the context of organ transplantation [35]. Thus, the role of self-efficacy in this context needs further exploration.…”

Prevalence and correlates of medication non-adherence among kidney transplant recipients more than 6 months post-transplant: a cross-sectional study

“…First, we assessed medication adherence by self-report, using a single instrument (the ITAS). Other methods of measuring adherence include electronic monitoring [27-29], clinicians’ collateral reports [30,31], serum assays for immunosuppressive medication concentrations [32-34], pill counts, and prescription refill and claims records [35]. Use of multiple methods, rather than a single method such as self-report, may be the most valid way to detect and measure non-adherence [36].…”

Taking immunosuppressive medications effectively (TIMELink): a pilot randomized controlled trial in adult kidney transplant recipients

“…The home visit, monthly telephone calls, and mailed transplant educational materials were delivered to provide equal attention time and perceived benefits to the control group. (23). Reliability has been established in temperatures ranging from )20 to 70°C and up to 95% humidity, is accurate to within two min per month, and has a reported 0.04 to 2% malfunction rate (24)(25)(26).…”

“…Each MEMS cap contains a battery and microelectronic circuitry that record a date and time with each removal of the cap from the medication vial. The batteries for the MEMS have a 36‐month battery‐life, can store up to 3800 medication events, and have been more than satisfactory for capturing 12 months of medication‐taking activity (23). Reliability has been established in temperatures ranging from −20 to 70°C and up to 95% humidity, is accurate to within two min per month, and has a reported 0.04 to 2% malfunction rate (24–26).…”