ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Care Processes and Structures Associated with Higher Medication Adherence: The Positive Adherence Study

A. Dabirzadeh1, B. Foster1, M. Dahhou1, S. Mital2

1Research Institute of the McGill University Health Centre, Montreal, QC, Canada, 2Hospital for Sick Children, Toronto, ON, Canada

Meeting: 2020 American Transplant Congress

Abstract number: 287

Keywords: Multicenter studies, Pediatric, Psychosocial

Session Information

Session Name: Psychosocial and Treatment Adherence

Session Type: Oral Abstract Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:45pm

 Presentation Time: 3:39pm-3:51pm

Location: Virtual

*Purpose: We aimed to identify care processes and structures that are independently associated with higher medication adherence among adolescent and young adult transplant recipients.

*Methods: We conducted a prospective, observational cohort study of 270 prevalent kidney, liver, and heart transplant recipients 14-25 y followed in 1 of 14 paediatric or 14 adult transplant programs across Canada. All patients were >3 months post-transplant and >2 months post-discharge. Patients were classified as adherent or non-adherent at baseline, 3mo and 6 mo based on the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS); adherent patients had missed no immunosuppressive doses in the prior 4 weeks. Transplant program directors and nurses at each program completed questionnaires regarding organization of care, composition of the team, and care processes/protocols. Program-level factors that varied substantially across programs were considered in the models as potential independent correlates of higher adherence. We used mixed models, with program as a random effect, accounting for clustering by program and for repeated adherence measures within patients, to identify independent correlates of adherence. Models were adjusted for non-modifiable patient-level factors that may act as confounders due to their association with adherence (age, sex, time since transplant, donor source, number of meds, primary caregiver [self vs. other], who prepares meds).

*Results: There were 66 kidney, 16 liver, and 17 heart recipients in paediatric programs, and 118 kidney, 42 liver and 11 heart recipients in adult programs. The median age was 20.3 y (IQR 17.2-23.2); median time since transplant 5 y (IQR 2.1-10.7); 119 (44%) were female. At baseline, 71.5% were adherent. Factors significantly independently associated with greater adherence were greater minimum prescribed frequency of routine blood work for those >3 y post-transplant, routine reminders for blood work and greater average time spent with nurse (Table 1). Male sex (0.52 [0.36,0.75]) and longer time since transplant (0.95 [0.92,0.99]) were associated with significantly poorer adherence. Living donor source was associated with significantly better adherence (2.24 [1.51,3.33]).

*Conclusions: Program-level factors related to the ‘culture of care, including intensity of routine follow-up and support to patients, are associated with medication adherence. This suggests that interventions at the program level may support better adherence.

Table 1
Format OR [95% CI] for good adherence
Minimum prescribed frequency of routine blood work (per 1 additional per y) 1.08 (1.02,1.14)
Routine reminders for blood work 1.53 (1.01,2.32)
Same nurse at each visit 1.15 (0.71,1.88)
Average time spent with nurse (per 5 min) 1.12 (1.04,1.21)
Pharmacist on care team 1.83 (0.69,4.83)
Self-management interventions offered 1.18 (0.73,0.92)
  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Dabirzadeh A, Foster B, Dahhou M, Mital S. Care Processes and Structures Associated with Higher Medication Adherence: The Positive Adherence Study [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/care-processes-and-structures-associated-with-higher-medication-adherence-the-positive-adherence-study/. Accessed May 11, 2025.

« Back to 2020 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences