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High noncompliance after kidney transplantation

More than half of all renal transplant patients who completed a questionnaire were determined to be noncompliant with their medication, and lack of knowledge about immunosuppressive medications was the only factor predictive of noncompliance in multivariate analysis.

Questionnaires were mailed to 270 adult transplant recipients with functioning grafts; of these, 95 responded, 52 of whom (55%) were noncompliant. Thirty-six were noncompliant on the basis of self-reports of noncompliance alone, eight were noncompliant on the basis of immunosuppressive drug levels alone, and eight were noncompliant on the basis of both. Age, sex, race, socioeconomic status and education did not differ significantly between compliant and noncompliant patients, and number of medications taken was associated with noncompliance in univariate but not multivariate analysis. The primary causes given for missed doses were forgetfulness (64%) and being away from home without medications (9%). Medication noncompliance was predictive of acute graft rejection. However, although most patients were aware of the implications of noncompliance, perception of risk did not influence compliance.

Am J Health-Syst Pharm 2003;60(3):266-9.

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