Factors that determine self-reported immunosuppressant adherence in kidney transplant recipients: a correlational study

Aims: To determine the factors related to immunosuppressant therapy adherence in kidney transplant recipients in Taiwan. Background: Adherence to immunosuppressant treatment is critical after kidney transplantation. Thus, the factors associated with self-reported medication adherence in kidney transplant recipients warrant investigation. Design: The study used a cross-sectional and correlation design. Methods: A convenience sample of 145 kidney transplant recipients was included. Structured questionnaires were used to collect data during 2012–2013. Multivariate linear regression was used to examine the factors related to immunosuppressant therapy adherence. Results: Over half of the participants were female (54·5%), mean age was 45·5 years, and mean year after transplant was 7·4. The mean score for medication adherence was 29·73 (possible score range 7-35). The results of the multivariate linear regression analysis showed that gender (male), low income with a high school or college education, years after transplantation and concerns about medication taking were negatively associated with adherence. Medication self-efficacy was positively associated with adherence. Therapy-related factors, partnerships with healthcare professionals and having private healthcare insurance did not significantly relate to immunosuppressant therapy adherence. Conclusions: Kidney transplant recipients demonstrated a high level of adherence. Strategies to enhance patients’ self-efficacy and alleviate concerns about medication may promote medication adherence. Male patients, those with a lower income and those with a higher education level, should be a focus of efforts to maintain adherence to the medication regimen.