Patient Self-Reported Adherence to and Perceptions Towards Immunosuppressive Medications at the Outpatient Renal Transplant Clinic at St. Joseph's Healthcare Hamilton (SJHH)
1Pharmacy, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
2Medicine, McMaster University, Hamilton, ON, Canada.
Meeting: 2015 American Transplant Congress
Abstract number: C218
Keywords: Immunosuppression, Kidney transplantation, Patient education, Rejection
Session Information
Session Name: Poster Session C: Psychosocial and Treatment Adherence
Session Type: Poster Session
Date: Monday, May 4, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Objectives
To gain insight into the immunosuppressant adherence of patients followed by the Outpatient Renal Transplant Clinic at St. Joseph's Healthcare Hamilton (SJHH) and to investigate the different medication management tools used by these patients.
Methods
This was a single-centre cross-sectional study using anonymous patient self-reported surveys administered in the waiting room of the Outpatient Renal Transplant Clinic at SJHH. The self-reported survey consisted of two validated questionnaires: Beliefs about Medicines Questionnaire (BMQ) and Immunosuppressant Therapy Adherence Instrument (ITAS). Eleven additional questions about compliance and medication tools were also created. The survey was reviewed for face validity. Participants only completed the survey once during the study period. Pharmacy refill histories and information about immunosuppressant (tacrolimus/cyclosporine) dose changes and drug levels were also collected to corroborate patient self-reported medication adherence.
Results
We had a survey response rate of 69.9% (N = 130) with 93.5% (N=73) participants reporting 100% adherence to their immunosuppressant medications (ITAS score=12). Participants reported an overall high BMQ necessity score (mean score: 22.3, N= 126) and an overall low BMQ concerns score (mean score: 13, N= 115). A main effects model looking at pharmacy refill histories, dosage changes of tacrolimus/cyclosporine, age and sex found no association between these variables and the self- reported ITAS score <12. A majority (73.8%) reported using one or more tools to manage their medications (N=96) and 64.8% (N=122) reported keeping an extra supply in case they run out.
Conclusion
Study participants reported an overall extremely high rate of adherence to immunosuppressant medications. A high overall score on the BMQ necessity score, low overall score on the BMQ concerns score and the use of tools and strategies to manage their immunosuppressant medications could explain this high self-reported adherence. However despite reporting an overall high adherence to immunosuppressants, the long-term effects of immunosuppressants continues to worry a majority of the study participants. In the future, we hope to create and implement a checklist to identify patients at high risk of medication non-adherence prior to and post renal transplant.
To cite this abstract in AMA style:
Kak K, Burger C, Treleaven D, Wallace C. Patient Self-Reported Adherence to and Perceptions Towards Immunosuppressive Medications at the Outpatient Renal Transplant Clinic at St. Joseph's Healthcare Hamilton (SJHH) [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/patient-self-reported-adherence-to-and-perceptions-towards-immunosuppressive-medications-at-the-outpatient-renal-transplant-clinic-at-st-josephs-healthcare-hamilton-sjhh/. Accessed May 14, 2025.« Back to 2015 American Transplant Congress