In transplantation, low therapeutic adherence is associated with an increased risk of rejection, chronic allograft dysfunction and graft loss. Improving adherence necessitates identifying its barriers, in order to set up appropriate actions. Negative perception of the treatment may constitute a barrier to adherence. Therefore, the aim of this study was to evaluate the relationship between adherence and patients' experiences towards their immunosuppressive (IS) treatment.

An observational cross-sectional monocenter study was conducted in 102 kidney adult transplant patients between September and November 2016. Adherence and patients' experiences towards their IS treatment were evaluated simultaneously, during their regular visit, using the Moriky 8-items (MMAS-8) and the MESI questionnaires. Patients' experience was considered negative for a MESI score>15. Age, sex, living environment (urban vs. rural), month and year of transplantation were collected. The relationship between MESI and MMAS-8 scores was explored using logistic regression. Pearson chi-square test, one way ANOVA or t-tests were used to study relationships between the MESI score and the covariates. Results were considered significant for p<0.05. Statistical analyses were performed in R software.

Included patients were 58.4±13.0 year-old and 67% were men. The mean post-transplantation delay was 8.4±6.4 years. The MESI score was >15 in 33% of the patients. There was a significant association between the MESI and MMAS-8 scores, with poorer adhesion in patients with MESI score >15 (MMAS-8=0.19±0.40 vs. 0.52±0.72, p=0.01). No significant association was found between the MESI score and age, sex, post-transplantation delay or living environment. Patients with high MESI score declared more suffering from discomfort and severe adverse effects, which they thought would never disappear, and believed that their IS treatment was useful but harmful.

This study confirmed the relationship between the negative perception of IS treatment and low adherence. Negative experience was reported in one third of the patients. Therefore, evaluating patients' experiences towards their IS treatment using the MESI questionnaire could help identifying barriers to adherence and should be included in the therapeutic education programs.

CITATION INFORMATION: Villeneuve C, Grau M, Essig M, Hegarat S, Zoughbi J, Marquet P, Monchaud C. Evaluating Patients' Experiences Towards Their Immunosuppressive Treatment: A Way to Improve Adherence. Am J Transplant. 2017;17 (suppl 3).

« Back to 2017 American Transplant Congress