Medication adherence among heart and/or lung transplant recipients: An exploratory study

Rebecca A O’Brien^1,2, Parisa Aslani², Maria A Ciccia¹, Jo-anne E Brien^1–3

¹Pharmacy Department, Therapeutics Centre, St Vincent’s Hospital, Sydney, NSW, Australia; ²Faculty of Pharmacy, University of Sydney, NSW, Australia; ³Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia

Objectives: To investigate medication nonadherence in heart and/or lung transplant recipients; to explore patients’ opinions about their medications and transplant experience; and to investigate strategies used to facilitate adherence.

Methods: A semi-structured questionnaire was developed to address the objectives of this exploratory study. Face-to-face interviews were conducted with inpatients and clinic outpatients at a large public teaching hospital.

Results: Thirty three patients consented to participate. Sixteen (48.5%) admitted to having missed a dose of their immunosuppressant medications at some time since the transplant, with five (15.2%) missing a dose in the two weeks prior to data collection. The main reasons for missing doses were ‘forgetfulness’ (n = 16, 48.5%) or ‘being busy with other things’ (9, 27.3%). Most nonadherence was unintentional, only 4 (12.1%) ever chose not to take a dose. Participants had strong opinions about their medications and condition. Most had a positive feeling towards their transplant and all had positive feelings about the team. Reported reasons for adherence included increased life span and quality of life. All but one of the participants used strategies or aids to facilitate adherence.

Conclusions: Self-reported nonadherence rates identified were low compared with literature reports for adherence in chronic disease and in other transplant populations. Participants’ opinions about their medications and transplant experience may have acted as a strong motivator for adherence.

Keywords: adherence, compliance, heart and lung transplantation, pharmacist