2017
DOI: 10.1136/bmjopen-2016-015411
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Non-adherence to immunosuppressants following renal transplantation: a protocol for a systematic review

Abstract: IntroductionAdherence to immunosuppressant medication is essential for renal transplant recipients. This review aims to summarise what is known about non-adherence, with a view to providing comprehensive evidence to inform strategies aimed at advancing adherent behaviour.Methods and analysisA systematic review of quantitative studies that report adherence to immunosuppressants in adult (over 18 years) renal transplant recipients. The review will follow the PRISMA (Preferred Reporting Items for Systematic Revie… Show more

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Cited by 16 publications
(9 citation statements)
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“…Psychiatric and psychological support is often necessary to favor the process of adaptation to transplant in the long term, since aspects of psychopathology have been analyzed by different authors in the post-transplantation, with results of lower levels of adherence (59,61,63,65).…”
Section: Discussionmentioning
confidence: 99%
“…Psychiatric and psychological support is often necessary to favor the process of adaptation to transplant in the long term, since aspects of psychopathology have been analyzed by different authors in the post-transplantation, with results of lower levels of adherence (59,61,63,65).…”
Section: Discussionmentioning
confidence: 99%
“…and manage outpatient clinic visits and tests; lack of such adherence is a major contributor to graft loss and other adverse KToutcomes. 7,8 To date, studies that have compared cognitive performance measures pre-and post-KT have been smaller, been cross-sectional, and/or lacked longer-term repeated measures of cognitive function; however, they collectively suggest that cognitive function improves from baseline levels up to 1 year after successful KT. 3,9214 Cognitive trajectories beyond 1 year are understudied, but they are critical to understanding the balance between restoration of kidney function and aging.…”
mentioning
confidence: 99%
“…The International literature evidenced factors as determinants of post-transplant noncompliance A review based on 38 articles estimated that the non-adherence rate is between 28% and 52%. In a meta-analysis, the chances of graft failure were seven times higher in non-adherent patients compared to adherent patients (23) and a study that used BAASIS® to evaluate 74 patients found 14.3% nonadherence. (10) However, the general score for nonadherence found would be higher than cited, with a score similar to results of a Brazilian randomized study that used an education intervention and found adherence of 46.4% in the control group and 14.5% in the intervention group (p=0.001).…”
Section: Discussionmentioning
confidence: 99%
“…(18) A prospective cohort study with 1,505 patients in which 924 (61.4%) underwent KTP showed that non-adherence increased continually from six months until three years of follow-up; this finding supports the early adoption of measures supporting adherence to immunosuppressive therapy. (24) Even considering that free release per se does not justify a greater adherence to immunosuppressant drugs, (23) it is possible to suggest that the influence of a number of health and treatment systems in Brazil helps improve adherence, once therapy is established in legislation by clinical protocols and guidelines, (3) establishing the triple scheme of immunosuppressant drugs as the better therapeutic proposal, assuring the access and free distribution of immunosuppressant to all transplanted individuals, and avoiding the negative financial impact on adherence. (25) The complex therapeutic regimen and with the excessive number of medications ingested daily, directly influence the adherence to the treatment.…”
Section: Discussionmentioning
confidence: 99%