Findings from Pharmacist-Performed Medication Adherence Assessments in Living Donor Kidney Transplant Candidates and Missed Medication Rates Early After Transplant
1Pharmacy, Hosp of Univ of Pennsylvania, Philadelphia, PA, 2Penn Transplant Institute and Pharmacy Dept, Hosp of Univ of Pennsylvania, Philadelphia, PA
Meeting: 2022 American Transplant Congress
Abstract number: 1607
Keywords: Kidney transplantation
Topic: Clinical Science » Ethics » 22 - Psychosocial and Treatment Adherence
Session Information
Session Name: Psychosocial and Treatment Adherence
Session Type: Poster Abstract
Date: Tuesday, June 7, 2022
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: Evaluation and monitoring for medication non-adherence (NA) is necessary pre- and post-kidney transplant (KTx) to optimize outcomes. This study aims to describe findings post-implementation of a standardized pre-KTx medication adherence assessment questionaire in LD KTx candidates at our center, and to analyze recorded missed medication rates 3 and 6 months (mo) post-KTx.
*Methods: This retrospective study included adult HIV-negative candidates who underwent a LD KTx at our center 7/1/2018-12/31/2020 and had ≥ 6 mo follow up. All candidates were seen by a KTx pharmacist for a standardized medication adherence assessment at their pre-KTx visits, and provided education based on findings. Candidates were: 1) considered to have “adherence concerns” if they reported missed or late medications within 2 weeks (wks) prior to assessment or ever stopped a medication without medical advice 2) considered “using adherence tools” if they reported pill box use, active medication list, or medication reminder(s). Data on missing medications were collected from standardized documentation at 3 and 6 mo post-KTx .
*Results: Among 150 candidates included, 63 (42%) had adherence concerns and 139 (93%) reported using adherence tools pre-KTx. There were no significant differences with adherence concerns by sex, race, prior transplant, dialysis, or formal education. Significantly more candidates with > high school education used adherence tools. 4 recipients (3%) had documented missed immunosuppression doses at 3 mo and none at 6 mo post-KTx.
*Conclusions: 1) LD KTx candidates with > high school education were more likely to use adherence tools. 2) Over 40% of candidates reported late/missing medications within 2 wks prior to their assessment or stopping medication(s) without medical advice. 3) Medication NA post-KTx is likely to be under-documented by providers. 4) Standardized medication adherence assessments in KTx candidates can allow for individualized education and potentially decrease medication NA.
| Parameter evaluated (n=150) | Percent |
| Pillbox | 57 |
| Active medication list | 74 |
| Medication reminder(s) | 23 |
| Auto-refill | 66 |
| Late medication(s) in past 2 wks | 15 |
| Missed medication(s) in past 2 wks | 23 |
| Ever stopped medication(s) without medical advice | 15 |
| Parameter (n) | Had adherence concerns, n, (%) | p value | Using adherence tools, n, (%) | p value |
| Male sex (n=87) vs female (n=63) | 39 (45%) vs 24 (38%) | 0.50 | 79 (91%) vs 60 (95%) | 0.36 |
| Black race (n=14) vs other (n=136) | 5 (36%) vs 58 (43%) | 0.78 | 13 (93%) vs 126 (93%) | 1.00 |
| <29 years old (n=21) vs older (n=129) | 12 (57%) vs 51 (40%) | 0.16 | 20 (95%) vs 119 (92%) | 1.00 |
| Re-KTx/ prior other txp (n=13) vs none (n=137) | 6 (46%) vs 57 (42%) | 0.78 | 12 (92%) vs 127 (93%) | 1.00 |
| On dialysis pre-KTx (n=79) vs none (n=71) | 31 (39%) vs 32 (45%) | 0.51 | 71 (90%) vs 68 (96%) | 0.22 |
| High school education or less (n=39) vs greater (n=111) | 15 (38%) vs 48 (43%) | 0.71 | 33 (85%) vs 106 (95%) | 0.04 |
To cite this abstract in AMA style:
Nguyen L, Samudralwar R, Forte A, Malat G, Christopher C, Rivera J, Ilori T, Liu X, Trofe-Clark J. Findings from Pharmacist-Performed Medication Adherence Assessments in Living Donor Kidney Transplant Candidates and Missed Medication Rates Early After Transplant [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/findings-from-pharmacist-performed-medication-adherence-assessments-in-living-donor-kidney-transplant-candidates-and-missed-medication-rates-early-after-transplant/. Accessed November 21, 2024.« Back to 2022 American Transplant Congress