Strategies to improve medication adherence in kidney transplant recipients: Addressing education and pill burden

Ana Carolina Brecher de Souza; João Daniel de Souza Menezes; Matheus Querino da Silva; Camila Borge de  Freitas; Luísa Carneiro  Single; Bárbara Beraldo de Lima; Emerson Roberto dos Santos; Renato Mendonça  Ribeiro; Maria Claudia Parro; Heloisa Cristina Caldas; Alba Regina de Abreu  Lima; Luís Cesar Fava Spessoto; Vania Maria Sabadoto Brienze; Júlio César  André; Rita de Cassia Helu Mendonça  Ribeiro

doi:10.23750/abm.vi.16187

Strategies to improve medication adherence in kidney transplant recipients: Addressing education and pill burden

Authors

Ana Carolina Brecher de Souza Center for Studies in Health Education Development (CEDES), Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil https://orcid.org/0000-0003-4651-2389
João Daniel de Souza Menezes Center for Studies in Health Education Development (CEDES), Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil https://orcid.org/0000-0001-8767-7556
Matheus Querino da Silva Center for Studies in Health Education Development (CEDES), Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil https://orcid.org/0000-0003-4569-2808
Camila Borge de Freitas Center for Studies in Health Education Development (CEDES), Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil https://orcid.org/0000-0003-4613-9297
Luísa Carneiro Single Center for Studies in Health Education Development (CEDES), Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil https://orcid.org/0000-0002-0198-4633
Bárbara Beraldo de Lima Center for Studies in Health Education Development (CEDES), Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil https://orcid.org/0000-0002-6258-9717
Emerson Roberto dos Santos Center for Studies in Health Education Development (CEDES), Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil https://orcid.org/0000-0002-9513-1083
Renato Mendonça Ribeiro School of Nursing of Ribeirão Preto - University of São Paulo https://orcid.org/0000-0002-0585-7367
Maria Claudia Parro Center for Studies in Health Education Development (CEDES), Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil https://orcid.org/0000-0003-0855-609X
Heloisa Cristina Caldas Center for Studies in Health Education Development (CEDES), Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil https://orcid.org/0000-0002-8303-3929
Alba Regina de Abreu Lima Center for Studies in Health Education Development (CEDES), Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil https://orcid.org/0000-0003-4332-4059
Luís Cesar Fava Spessoto Center for Studies in Health Education Development (CEDES), Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil https://orcid.org/0000-0002-4697-5757
Vania Maria Sabadoto Brienze Center for Studies in Health Education Development (CEDES), Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil https://orcid.org/0000-0002-1727-2710
Júlio César André Center for Studies in Health Education Development (CEDES), Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil https://orcid.org/0000-0002-0549-4527
Rita de Cassia Helu Mendonça Ribeiro Center for Studies in Health Education Development (CEDES), Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil https://orcid.org/0000-0002-1016-0484

DOI: https://doi.org/10.23750/abm.vi.16187

Keywords:

kidney transplantation, medication adherence, immunosuppressive therapy, patient education, medication regimen complexity

Abstract

Background and aim: Adherence to immunosuppressive therapy is crucial for the success of kidney transplantation. This study aimed to evaluate medication adherence among kidney transplant recipients (KTRs) and identify factors associated with non-adherence.

Methods: A cross-sectional study was conducted with 100 KTRs from a single transplant center. Adherence was assessed using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS). Sociodemographic and clinical data were collected through interviews and medical records. Logistic regression analysis was performed to identify factors associated with non-adherence.

Results: The prevalence of non-adherence was 65%. Delayed medication intake (≥2 hours) was reported by 36% of KTRs. Lower education levels were associated with a higher risk of delayed medication intake (OR=3.14; 95%CI: 1.28-7.72; p=0.012). A higher number of pills per dose was associated with a higher risk of non-adherence (OR=1.54; 95%CI: 1.03-2.30; p=0.036).

Conclusions: Non-adherence to immunosuppressive therapy was common among KTRs. Lower education levels and a higher number of pills per dose were associated with non-adherence. Interventions targeting these factors, such as patient education and simplification of medication regimens, may improve adherence and transplant outcomes.

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