Differences in Reported Barriers to Immunosuppression Adherence Among a Cohort of Pediatric Renal Transplant Recipients from the United States and Canada.

O. Bignall II,^1,2 A. Pai,² S. Amaral,³ S. Furth,³ N. Bergman,² J. Goebel,⁴ The TAKE-IT Study Investigators, B. Foster.⁵

¹Nephrology and Hypertension, Cincinnati Children's Hospital, Cincinnati, OH
²Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital, Cincinnati, OH
³Nephrology, The Children's Hospital of Philadelphia, Philadelphia, PA
⁴Nephrology, Children's Hospital of Colorado, Aurora, CO
⁵Nephrology, Montreal Children's Hospital, Montreal, QC, Canada.

Meeting: 2016 American Transplant Congress

Abstract number: D161

Keywords: Immunosuppression, Kidney transplantation, Pediatric, Psychosocial

Session Information

Session Name: Poster Session D: Kidney-Pediatrics

Session Type: Poster Session

Date: Tuesday, June 14, 2016

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Halls C&D

Aim: The purpose of this study was to examine differences in reported barriers to immunosuppressant adherence (IA) between a cohort of pediatric renal transplant recipients from the United States (US) and Canada.

Background: Adolescents and young adults (AYA) are at highest risk for poor IA, threatening their health and allograft survival. Among adult renal transplant recipients, comparisons of barriers to IA across geographic regions have shed light on country-specific variations in the determinants of health outcomes. Yet, there is little comparative data on country-specific differences in IA barriers among pediatric renal transplant recipients.

Methods: Data were collected as part of the TAKE-IT study, a large multi-center randomized controlled trial of an adherence intervention for AYA renal transplant recipients from the US and Canada. A total of 170 participants (N=111 US, N=59 Canadian) completed detailed, baseline demographic questionnaires (incl. insurance status) and the Medical Adherence Measure Medication Module.

Results: Canadians most frequently reported IA barriers were forgetfulness (56%), interference with activity (34%), and absence from home (31%). In the US, forgetfulness (27%), interference with activity (24%), and absence from home (16%), were also most common. More US respondents (35%) reported that they did not miss medications than Canadians (17%). Chi-square analyses found significant associations between insurance status and IA barriers of forgetfulness X2(3, N=169) = 14.6, p˂.01; absence from home X2(3, N=169) = 11.4, p=.01; and medication refusal X2(3, N=169) = 8.044, p=.05.

Conclusions: Pediatric renal transplant recipients in the US were less likely to report missing medications than those in Canada. In both groups forgetfulness, interference with activity, and absence from home were the most commonly reported IA barriers. Similar patterns of barriers to IA may suggest universal application of adherence interventions between these groups.

CITATION INFORMATION: Bignall II O, Pai A, Amaral S, Furth S, Bergman N, Goebel J, The TAKE-IT Study Investigators, Foster B. Differences in Reported Barriers to Immunosuppression Adherence Among a Cohort of Pediatric Renal Transplant Recipients from the United States and Canada. Am J Transplant. 2016;16 (suppl 3).

To cite this abstract in AMA style:

II OBignall, Pai A, Amaral S, Furth S, Bergman N, Goebel J, Investigators TheTAKE-ITStudy, Foster B. Differences in Reported Barriers to Immunosuppression Adherence Among a Cohort of Pediatric Renal Transplant Recipients from the United States and Canada. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/differences-in-reported-barriers-to-immunosuppression-adherence-among-a-cohort-of-pediatric-renal-transplant-recipients-from-the-united-states-and-canada/. Accessed May 11, 2025.

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