To analyse the influence of dialysis type on adherence to immunosupressive medications (IS) and HRQoL before and after KT.
Material and Methods.
Between years 2004-2008 156 dialysis patients responded to the15 dimension 15D HRQoL questionnaire. 62 of them received a KT, and were asked to fill in it again. Non-respondents and graft losses constituted the control group. The adherence to IS and other medications was investigated with the BAASIS and VAS scales.Medication complexity index (MCI) and recipient risk score (RRS) to compare co-morbidities were investigated.
Response rate to the HRQoL questionnaire after transplantation was 70%. Previous dialysis modality affected the response rate (75% of HHD, 80% PD and 43% in-center-HD). Respondents and controls did not differ in terms of age (median 55y), comorbidities, time on dialysis (median 26mo), time from transplantation (median 4y) or GFR (55ml/min).
Adherence-survey response rate was 72% (65% were on home-dialysis). None of the patients stopped or modified doses of IS. Two patients forgot to take IS once, but 20% admitted taking them more than 2 hours before/after the expected time. Adherence to IS was 98% and 95% for other medications.Mean number of medications was 9; mean pill burden was 14 and mean MCI was 15 per patient. PD patients received less pills than HD-patients (P=0,028).
Overall HRQoL was improved after KT. However, it only improved significantly in in-center-HD patients in the dimensions of moving, seeing, usual activities and discomfort/symptoms. Home dialysis patients had better HRQoL during dialysis. The control group had lower HRQoL during dialysis than the study group during dialysis.
Adherence to IS after KT was satisfactory in this population of mainly previous home dialysis patients, dose scheduling being the most difficult task. Home dialysis patients have a fairly good HRQoL even during dialysis and KT does not improve it much, whereas in-center-HD patients benefit from KT in terms of improved HRQoL.
To cite this abstract in AMA style:Ortiz F, Roine R, Malmström R, Koskinen P. Health-Related Quality of Life and Adherence to Medication in Kidney Transplantation: A Longitudinal Analysis [abstract]. Am J Transplant. 2013; 13 (suppl 5). http://atcmeetingabstracts.com/abstract/health-related-quality-of-life-and-adherence-to-medication-in-kidney-transplantation-a-longitudinal-analysis/. Accessed November 19, 2017.
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