Promoting Adherence to Transplant Medication Regimens: A Review of Behavioral Analysis

Abstract

Failure to adhere to complex behavioral regimens has been a significant and long-standing problem in healthcare. Transplant recipients are one patient population that needs to learn and incorporate a multidimensional regimen of behaviors into their lives. The literature indicates that not all transplant recipients adhere to their medication regimens, which can lead to graft loss and possibly death. Behavioral analysis is often used to increase adherence to health-related regimens and has been effective for a variety of health conditions. The use of behavioral analysis as a strategy to promote adherence behaviors has not been reported in the transplant literature. Transplant coordinators and clinicians should learn the principles of behavioral analysis and apply them to the care of transplant recipients to facilitate recipients' lifelong adherence behaviors.

Impact of clinical pharmacy services on renal transplant patients’ compliance with immunosuppressive medications

“…With the cost of immunosuppression therapy typically costing greater than $10 000 per year, the numerous medications required, the complexity of medication dosing, and the risk of adverse experiences, the risk of medication non‐compliance is great [1,6,7]. Because of the frequency of medication non‐compliance and possible adverse consequences, interventions to encourage medication compliance in solid organ transplant patients are needed [1,8–10].…”

Nursing and Transplant Coordination: A Call for Clarity

“…Although several extensive reviews 32,33 of noncompliance in transplant patients failed to mention nurses or coordinators, the role of transplant coordinators in preventing noncompliance was cited by several authors. 22,34,35 Newton 36 reviewed the behavioral analysis literature as a possible evidence base for transplant coordinators to use in designing interventions to enhance compliance.…”

Self-Care Guidelines: Finding a Common Ground

“…Various behavioral strategies have been used in attempts to ensure patient compliance. 7 Precise instructions are given by the transplant team on how, when, and why medications are to be taken. With the decreasing inpatient length of stay and the possibility of comorbidities, these instructions may be fragmented or forgotten.…”