Factors affecting adherence of recipients to immunosuppressive therapy after liver and kidney transplantation

Abstract

Background: Organ transplantation has important outcomes: decreased mortality, increased graft survival, reduced morbidity, and improved quality of life. One of the most important preventable factors that negatively affect these outcomes and put the success of solid organ transplants at risk in organ transplant recipients is non-adherence to immunosup pressive treatment. Aim: The purpose of this study is to examine the adherence of recipients to immunosuppres sive therapy after liver and kidney transplantation and affecting factors. Methods: This is a descriptive study. A total of 310 patients who underwent liver or kidney transplantation at a university hospital between February and July 2015 were included in the study. Data were collected with Sociodemographic and Clinical Characteristic Form, SF-36 Quality of Life Scale, and Immunosuppressant Therapy Adherence Scale. The Mann–Whitney U test, Fisher’s exact test, and Chi-square test were used to analyze the data. Factors affecting adherence were examined by univariate logistic regression analysis. Results: The edits made to the sentence ‘Immunosuppressive Therapy Adherence Scale scores of the recipients ranged between 7 and 12 with a mean of 11.34 ± 0.81 and recipients who had Immunosuppressive Therapy Adherence Scale scores of <12 were considered non adherent. Age, time elapsing after transplantation, total number of drugs used, education on drug use, and the quality of life mental component summary score were found to affect adher ence to immunosuppressive therapy. Gender, educational status, marital status, employment status, donor and organ transplant type, and the quality of life physical component summary score were found to be ineffective in adherence to immunosuppressive therapy. Conclusion: Organ transplant recipients adherent to immunosuppressive therapy were found to be older, use a higher number of drugs, and have a higher mental health summary scores than those not adherent to the immunosuppressive therapy. Besides, a higher rate of the recipients adherent to immunosuppressive therapy was found to receive education on medication use and have a shorter time elapsing after transplantation. It can be recom mended that nurses should be aware of the factors likely to affect adherence to immuno suppressive therapy, evaluate the adherence regularly by using a valid and reliable tool, and perform effective interventions.