Purpose: Though poor medication adherence among adult kidney transplant patients is alarmingly high with distressing consequences, no one has systematically examined medication non-adherence in those waiting for a kidney transplant.

Methods: Using a descriptive, longitudinal design, 35 adults on the wait list for kidney transplant were followed for 4 months with electronic medication monitoring. One twice-daily administered medication was monitored to simulate a BID post-transplant immunosuppressant. Baseline medication self-efficacy, perceived health, perceived health difficulty, social support, and perceived barriers to medication adherence were obtained.

Results: Mean age was 52 years (range 21-71) with 66% male and 77% Caucasian. Diabetes was the etiology of kidney disease in 37% (13/35). Just over half, 51% (18/35,) were non-adherent with their medications. Medication non-adherence was significantly correlated with medication self-efficacy r = 0.4358 (p=0.0426) and not significantly correlated with perceived health r = 0.141 (p=0.4316), perceived health difficulty r = 0.0524 (p=0.7754), social support r = -0.18496 (p=0.3028) or perceived medication barriers r = 0.22658 (p=0.2048).

Conclusions: A distressing numbers of those on the wait list for kidney transplant are non-adherent with their twice daily administered medications. Interventions are needed for those on the wait list to prepare for immunosuppressive medication adherence after transplant. Enhancing self-efficacy, or confidence in medication taking, may provide an opportunity for achieving this goal.

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