Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Medication adherence is key to kidney transplant (KTx) success. Our center implemented standardized medication adherence assessment and education in KTx candidates undergoing living donor KTx. We herein report our initial findings.
*Methods: This was a retrospective study of adult HIV negative KTx candidates who underwent living donor KTx at our center 7/1/18-8/29/19. All candidates were seen by a transplant pharmacist for a standardized medication adherence assessment and provided education based on findings. Candidates were: 1) considered to have “adherence concerns” if they reported missed or late medications in the preceeding 2 wks or ever stopped medication without medical advice 2) considered “using adherence tools” if they reported pill box use, or active medication list, or medication reminder(s). Data on missing medications were collected from standardized documentation at 1 and 6 mo KTx visits.
*Results: Assessments occurred at a mean (SD) of 9 (±20) days pre-KTx. One hundred candidates were assessed and included in the study. Data on missed/late medications was unavailable for 2 candidates (Table 1). Despite all candidates ≤ 29 yrs reporting adherence tools use, they had significantly more reported adherence concerns versus those older (Table 2). There were no significant differences with adherence concerns by male gender, black race, re-KTX, or ≤ high school education. There were no significant differences in adherence tool use by these same parameters with the exception of candidates with≤ high school education, who reported significantly greater adherence tools use. One (1%) KTx recipient at 1 mo and 3/51 (6%) at 6 mo were missing medications.
*Conclusions: 1) Despite higher report of adherence tools use, younger KTx candidates had significantly more reported adherence concerns than older candidates. 2) We found that over a quarter of candidates reported late/missing medications within 2 wks prior to their assessment or stopping medication(s) without medical advice. 3) Standardized medication adherence assessments in candidates can allow for individualized education and potentially improve KTx medication adherence.
|Pill box use||56|
|Active medication list||75|
|Late medication(s) in the past 2 wks||12|
|Missed medication(s) in the past 2 wks||16|
|Ever stopped medication(s) without medical advice||24|
|Parameter (n)||Had adherence concerns, n, (%)||p value||Using adherence tools, n, (%)||p value|
|Male gender (n = 56) vs female (n = 44)||26 (46) vs 15 (34)||0.2273||46 (82) vs 38 (86)||0.5972|
|Black race (n = 10) vs other (n = 90)||3 (30) vs 38 (42)||0.5197||9 (90) vs 75 (83)||1.000|
|Age ≤ 29 yrs (n = 13) vs older (n = 87)||9 (69) vs 32 (37)||0.0354||13 (100) vs 71 (82)||0.1206|
|Re-transplant (n = 13) vs primary (n = 87)||7 (54) vs 34 (39)||0.3716||11 (85) vs 73 (84)||1.000|
|High school education or less (n = 30) vs greater (n = 70)||9 (30) vs 32 (46)||0.1846||26 (87) vs 58 (83)||0.0447|
To cite this abstract in AMA style:Trofe-Clark J, Malat G, Norris M, Sawinski D, Bleicher M, Bloom R. Medication Adherence Assessment Findings in Kidney Transplant Candidates Undergoing Living Donor Transplant [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/medication-adherence-assessment-findings-in-kidney-transplant-candidates-undergoing-living-donor-transplant/. Accessed November 23, 2020.
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