Lalić Jelena, Veličković-Radovanović Radmila, Mitić Branka, Paunović Goran, Cvetković Tatjana
Department of Pharmacy, Faculty of Medicine, University of Niš, Niš, Serbia.
Med Princ Pract. 2014;23(4):351-6. doi: 10.1159/000362792. Epub 2014 Jun 6.
To assess the degree of immunosuppressive medication adherence in kidney transplant patients (KTPs) and to determine if there is a difference in the rate of adherence to tacrolimus (Tac), cyclosporine (CsA) and sirolimus (Sir).
From a total of 63 KTPs treated at the Clinic of Nephrology, Clinical Centre Niš, Serbia, 60 participated in the study by responding to questionnaires. They were divided into the adherence group (n = 43) and the nonadherence group (n = 17) according to their degree of adherence which was measured using a validated survey form, the simplified medication adherence questionnaire. The KTP adherence to the different immunosuppressive regimens (Tac, CsA and Sir) was compared. Statistical analysis was performed using the Student t test.
Adherence was observed in 43 (71.7%) patients, and only 17 (28.3%) did not follow the prescribed therapy. The estimated glomerular filtration rate was significantly lower in the nonadherence group (38.52 ± 18.22 ml/min) than in the adherence group (52.43 ± 16.91 ml/min, p < 0.05). With regard to the Tac level, a significant difference was also found between the adherers and the nonadherers (6.30 ± 2.06 vs. 5.0 ± 1.52 ng/ml, p < 0.05).
The KTPs in this study demonstrated a high level of adherence. Nonadherence was associated with worse graft function and a lower Tac level. Knowledge about the degree of adherence could help the early identification of nonadherent patients and the development of strategies to improve this.
评估肾移植患者（KTPs）免疫抑制药物的依从程度，并确定他克莫司（Tac）、环孢素（CsA）和西罗莫司（Sir）的依从率是否存在差异。
在塞尔维亚尼什临床中心肾脏病科接受治疗的63例KTPs中，60例通过回答问卷参与了本研究。根据使用经过验证的调查问卷形式（简化药物依从性问卷）测量的依从程度，将他们分为依从组（n = 43）和不依从组（n = 17）。比较了KTPs对不同免疫抑制方案（Tac、CsA和Sir）的依从性。采用学生t检验进行统计分析。
43例（71.7%）患者表现出依从性，只有17例（28.3%）未遵循规定治疗。不依从组的估计肾小球滤过率（38.52±18.22 ml/min）显著低于依从组（52.43±16.91 ml/min，p<0.05）。关于他克莫司水平，依从者和不依从者之间也发现了显著差异（6.30±2.06对5.0±1.52 ng/ml，p<0.05）。
本研究中的KTPs表现出较高的依从性。不依从与较差的移植肾功能和较低的他克莫司水平相关。了解依从程度有助于早期识别不依从患者并制定改善策略。
