Promoting Adherence to Transplant Medication Regimens: A Review of Behavioral Analysis

Journal of Transplant Coordination, Vol. 9, Number 1, March 1999 administering the medications. However, studies have shown that at least one third of patients do not adhere to their drug regimens.3,4,5 Conrad4 suggests that compliance rates with medication regimens over long periods tend to approach 50%. It has also been shown that multiple medications and/or multiple doses per day of a medication—a common pattern for transplant recipients—tend to have higher rates of nonadherence.6 For transplant recipients, not adhering to the immunosuppressant regimen can result in rejection, graft loss, and even death.3 It has been documented that transplanted allografts are needlessly lost, due to recipient nonadherent behaviors.7 In one study,3 a third of liver transplant recipients were nonadherent with their immunosuppressant medication regimen. Perhaps the most surprising finding is that nonadherent behaviors generally occur when early posttransplant complications have been surpassed and long-term engraftment seems to have been achieved.7 According to some researchers, medication nonadherence causes more graft loss than does uncontrollable rejection in compliant recipients.3