Factors predictive of medication nonadherence after renal transplantation: a French observational study.

Lionel Couzi, Bruno Moulin, Marie-Pascale Morin, Laetitia Albano, Michel Godin, Benoit Barrou, Eric Alamartine, Emmanuel Morelon, Sandrine Girardot-Seguin, Laurence Mendes, David Misdrahi, Elisabeth Cassuto, Pierre Merville
Transplantation Journal. 2013-01-01; 95(2): 326-332
DOI: 10.1097/TP.0b013e318271d7c1

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1. Transplantation. 2013 Jan 27;95(2):326-32. doi: 10.1097/TP.0b013e318271d7c1.

Factors predictive of medication nonadherence after renal transplantation: a
French observational study.

Couzi L(1), Moulin B, Morin MP, Albano L, Godin M, Barrou B, Alamartine E,
Morelon E, Girardot-Seguin S, Mendes L, Misdrahi D, Cassuto E, Merville P.

Author information:
(1)CHU de Bordeaux, Hôpital Pellegrin, Service de Néphrologie et Transplantation
Rénale, Bordeaux, France.

BACKGROUND: There have been few prospective studies on the natural history of
nonadherence (NA) in kidney transplant recipients (KTRs) over time. The
objective of this study was to prospectively evaluate the rate of and risk
factors for NA in a French cohort of KTRs.
METHOD: A total of 312 KTRs from eight French transplantation centers were
included in this prospective, noninterventional cohort study. A
computer-learning software package (the Organ Transplant Information System) was
made available to all patients.
RESULTS: Using the four-item Morisky scale, we showed that 17.3%, 24.1%, 30.7%,
and 34.6% of patients were nonadherent at posttransplant month 3 (M3), M6, M12,
and M24, respectively. Young age was predictive of NA at M6, M12, and M24.
Surprisingly, simple treatment regimens including a small number of doses per
day and a small number of tablets per day were associated with NA at M3 and M12,
respectively. Other factors predictive of NA included failure to use the Organ
Transplant Information System software package at M6 and patient reports of
adverse events at M12 and M24. Importantly, we observed that physicians
underestimated the prevalence of adverse events when compared to patient
CONCLUSION: Our observed rate of medication NA in France is consistent with
rates reported in previous studies. We found variability in NA risk factors over
time as well as an unexpected risk factor (simple treatment regimens). These
findings will be useful in developing effective adherence-promoting

DOI: 10.1097/TP.0b013e318271d7c1
PMID: 23149477 [Indexed for MEDLINE]

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