Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands.
Department of Internal Medicine, Division of Nephrology, Leiden University Medical Center, Leiden, Netherlands.
Transpl Int. 2022 Feb 7;35:10073. doi: 10.3389/ti.2022.10073. eCollection 2022.
Medication nonadherence to immunosuppressants is a well-known risk factor for suboptimal health outcomes in kidney transplant recipients (KTRs). This study examined the relationship between illness perceptions and medication nonadherence in prevalent Dutch KTRs and whether this relationship depended on post-transplant time. Eligible KTRs transplanted in Leiden University Medical Center were invited for this cross-sectional study. The illness perceptions and medication nonadherence were measured validated questionnaires. Associations between illness perceptions and medication nonadherence were investigated using multivariable logistic regression models. For the study, 627 participating KTRs were analyzed. 203 (32.4%) KTRs were considered nonadherent to their immunosuppressants with "taking medication more than 2 h from the prescribed dosing time" as the most prevalent nonadherent behaviour ( = 171; 27.3%). Three illness perceptions were significantly associated with medication nonadherence: (adjusted odds ratio [OR] = 1.07; 95% confidence interval [CI], 1.00-1.14), (OR = 1.07; 95%CI,1.00-1.14), and (OR = 1.11; 95%CI,1.01-1.22). The relationships between illness perceptions and medication nonadherence did not differ depending on post-transplant time (-values ranged from 0.48 to 0.96). Stronger negative illness perceptions are associated with medication nonadherence to immunosuppressants. Targeting negative illness perceptions by means of psychoeducational interventions could optimize medication adherence and consequently improve health outcomes in KTRs.
免疫抑制剂用药依从性差是导致肾移植受者（KTR）健康结果不佳的已知危险因素。本研究调查了荷兰 KTR 中普遍存在的疾病认知与用药不依从之间的关系，以及这种关系是否取决于移植后时间。莱顿大学医学中心的合格 KTR 受邀参加这项横断面研究。使用经过验证的问卷测量疾病认知和用药不依从情况。使用多变量逻辑回归模型研究疾病认知与用药不依从之间的关联。在这项研究中，分析了 627 名参与的 KTR。203 名（32.4%）KTR 被认为不依从其免疫抑制剂，最常见的不依从行为是“服药时间比规定时间晚 2 小时以上”（= 171；27.3%）。三种疾病认知与用药不依从显著相关：感知疾病的严重程度（调整后的优势比[OR] = 1.07；95%置信区间[CI]，1.00-1.14）、感知疾病的易感性（OR = 1.07；95%CI，1.00-1.14）和感知疾病的后果（OR = 1.11；95%CI，1.01-1.22）。疾病认知与用药不依从之间的关系不因移植后时间而异（-值范围为 0.48 至 0.96）。更强烈的负面疾病认知与免疫抑制剂的用药不依从有关。通过心理教育干预来靶向负面疾病认知，可能会优化用药依从性，从而改善 KTR 的健康结果。
