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Pattern and associated factors of adherence to immunosuppressive medications in kidney transplant recipients at a referral center in Iran

Authors Moradi O, Karimzadeh I, Davani-Davari D, Shafiekhani M, Sagheb MM

Received 20 December 2018

Accepted for publication 12 March 2019

Published 8 May 2019 Volume 2019:13 Pages 729—738

DOI https://doi.org/10.2147/PPA.S198967

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Ms Justinn Cochran

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen


Omid Moradi,1 Iman Karimzadeh,2 Dorna Davani-Davari,2 Mojtaba Shafiekhani,2 Mohammad Mahdi Sagheb3

1Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran; 2Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran; 3Nephrology-Urology Research Center and Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Purpose: Ever increasing number of patients who receive kidney transplantation as a therapeutic option, approaches to increase graft survival as well as to identify factors that reduce the treatment outcomes should be taken into account. One of the heightened concerns after transplantation is non-adherence to immunosuppressive medications, which increases the risk of kidney failure or even rejection. The aim of this study was to evaluate factors associated with immunosuppressant medications adherence in kidney transplant recipients.
Patients and methods: Data were collected from 100 eligible kidney transplant patients referring to Shiraz Motahhari clinic and a private office of an attending nephrologist during 18 months. Adherence to immunosuppressive medications was assessed by Basel assessment of adherence to immunosuppressive medication scale at 2 time points.
Results: According to the findings, 55% of patients did not adhere to their post-transplantation immunosuppressive medications. The rate of adherence to immunosuppressive medications was not either statistically or clinically significant between time points zero and six months. None of the investigated factors including demographic, clinical and social-economical-cultural factors were significantly associated with patients’ adherence to immunosuppressive regimen. Furthermore, there was no statistically significant association between immunosuppressive medication adherence and acute kidney rejection.
Conclusion: The rate of non-adherence to immunosuppressive medications was high. These data can be exploited by both physicians and policymakers to improve the rate of adherence to immunosuppressive medications amongst kidney transplant recipients.

Keywords: kidney transplantation, medication adherence, immunosuppressive agents


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