Study On Factors Related To Drug Compliance Of Immunosuppressive Drugs In Kidney Transplant Recipients

Objective:1.To describe the current status of immunosuppressive medication adherence in kidney transplant recipients.2.To describe the perceived barriers of medication adherence and self-efficacy on medication taking among kidney transplant recipients.3.To discuss the influence of social demographical factors,social support,immunosuppressive medication(ISM)treatment satisfaction,knowledge of ISM,ISM taking barriers and self-efficacy on long-term ISM use.Methods:A cross-sectional design was used in this study,and convenience sampling was used to recruite kidney transplant recipients on follow-up visits in Nanfang Hospital affiliated to South Medical University.The investigation instruments included a self-designed general condition questionnaire,Basel Assessment of Adherence with Immunosuppressive Medication Scale,Long-term Medication Behavior Self-efficacy Scale,Immunosuppressant Therapy Barrier Scale,and Treatment Satisfaction Questionnaire for Medication,Perceived Social Support Scale and Patient-perceived Medication Knowledge in Medication Use Scale.IBM SPSS 23.0 was used to perform statistical analysis.The statistical analysis methods included descriptive analysis,correlation analysis,one-way ANOVA and establishing a multiple stepwise regression model.Results:Totally 233 questionnaires were handed out and 221 returned,among which,217 were valid.Medication non-adherence rate was 44.7%in this study.Timely non-adherent was the most serious aspect,namely,37.4%KTRs had been taken ISM more than two hours before or after the prescribed dosing time of all the recruited KTRs,13.6%KTRs had missed taking at leastone dose of ISM,Moreover,eight KTRs had altered the prescribed amount of their ISM and two KTRs had stopped taking their medication completely in the past four weeks.There was a significant difference on medication adherence between KTRs of different organ sources(t=-2.497,p=0.036).The ISM adherence on those who had received their allograft from their relatives’ performed worse than those from hospitals.Correlation analysis showed that the longer the KTRs after the operation,the worse their medication adherence would be(r=0.225,p=0.001).The higher level of social support they perceive,the better their medication adherence(r=-0.190,p=0.005).The more self-efficacy KTRs perceive on personal attitude and task-related and behavioral aspects,the better their medication adherence would be(r=-0.134,p=0.048;r=-0.134,p=0.047).Moreover,KTRs would perform better on medication adherence if they perceived less on uncontrollable or controllable barriers and if they are more satisfied with the possible influence of ISM side-effects on their body(r=0.275,p=0.000;r=0.200,p=0.003).And their ISM adherence would be better if they had a better master of ISM’s interaction knowledge(r=-0.145,p=0.033).The multiple stepwise regression model showed that the uncontrollable barriers,friends’ support,organ source and the time post the kidney transplantation are the main influencing factors on medication adherence in KTRs,and the above four variables could explain 19.6%of the total variance variation on ISM adherence in kidney transplant recipients.Conclusion:KTRs are at high rate of ISM non-adherence in this study.Considering the significance of ISM,integrated interventions should be taken from recipients,medical staff and KTRs’ social support systems’ to make KTRs aware of the serious consequences resulting form medication non-adherence and the strategies to maintain good medication adherence,helping them perform better on adherence to ISMs.