Compliance and Noncompliance in Kidney Transplant Patients: Cues for Transplant Coordinators

Abstract

Journal of Transplant Coordination, Vol. 9, Number 2, June 1999 respondents reported noncompliance with immunosuppressants; lack of compliance was associated with being single, male, and less knowledgeable about medication administration, and having lower scores on several psychosocial scales. Using pill counts to assess medication noncompliance among 113 patients during the first 12 months posttranplantation, Hilbrands et al7 found that 23% of respondents were noncompliant with cyclosporine. Although these authors did not find a strong relationship between noncompliance and several demographic variables, compliance was noted to increase markedly following rejection episodes. Finally, in our recently reported analyses of data gathered by questionnaires for 519 renal allograft recipients and by chart review for a subset of 397 (76.5%), approximately 18% of patients reported that they forgot to take, decided not to take, or adjusted the dose or frequency of an immunosuppressive medication within the 4 weeks prior to data collection.8 Noncompliance was associated with demographic variables (younger age, male sex, nonwhite race), characteristics of the transplant (longer time since transplantation), and health beliefs (beliefs that posttransplant symptoms will persist and that medications are not effective). Research to date concerning levels and predictors of noncompliance has yielded results that are not easy to Compliance and noncompliance in kidney transplant patients: cues for transplant coordinators