Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
Department of Psychiatry, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
Psychol Health Med. 2020 Jan;25(1):91-101. doi: 10.1080/13548506.2019.1622745. Epub 2019 May 30.
Nonadherence to immunosuppressive medications after kidney transplantation is a major risk factor for allograft rejection and graft loss. Transplant recipients tend to conceal nonadherence in clinical settings. We conducted an internet-based cross-sectional survey aimed to clarify the prevalence and risk factors of patient nonadherence after kidney transplantation in Japan. The Basel Assessment of Adherence to Immunosuppressive Medication Scale (BAASIS©) was used to detect nonadherence. In this survey, patients were asked about their relationship with medical staff and their self-efficacy for taking medication, along with other questions. A total of 219 kidney transplant recipients were included in the analysis. Ninety-four demonstrated nonadherence (42.7%). The following factors were associated with nonadherence: short dialysis period prior to transplantation; undergoing transplantation at least twice; male sex; lack of satisfaction with the explanation of immunosuppressive medication; and absence of medical staff to consult upon forgetting to take drugs. The nonadherence group reported low self-efficacy for medication in many settings. This anonymous survey provides valuable insight into the actual nonadherence rate, factors associated with nonadherence, and life situations that may complicate medication-taking.
肾移植后免疫抑制药物治疗依从性差是同种异体移植物排斥和移植物丢失的主要危险因素。移植受者在临床环境中往往隐瞒用药依从性差的情况。我们进行了一项基于互联网的横断面调查，旨在阐明日本肾移植后患者不依从的发生率和危险因素。采用巴塞尔评估免疫抑制药物依从性量表（BAASIS©）来检测不依从性。在这项调查中，患者被问及他们与医务人员的关系以及他们服药的自我效能，以及其他问题。共有 219 名肾移植受者纳入分析。94 名患者表现出不依从（42.7%）。以下因素与不依从有关：移植前透析时间短；至少接受过两次移植；男性；对免疫抑制药物解释不满意；忘记服药时没有医务人员咨询。不依从组报告在许多情况下对药物治疗的自我效能较低。这项匿名调查提供了有价值的见解，了解实际的不依从率、与不依从相关的因素以及可能使服药复杂化的生活情况。
