Adult ; Fatigue/psychology ; Female ; Follow-Up Studies ; Humans ; Immunosuppressive Agents/therapeutic use* ; Kidney Transplantation/psychology* ; Male ; Medication Adherence/statistics & numerical data* ; Middle Aged ; Postoperative Complications/prevention & control ; Postoperative Complications/psychology* ; Quality of Life ; Self Report ; Time Factors ; Transplant Recipients/psychology*
Abstract
PURPOSE: The purpose of this study was to investigate the relationship between immunosuppressant-related symptom experience (SE) and adherence to immunosuppressant regimens among kidney transplant (KT) recipients.
METHODS: A total of 239 KT recipients on an immunosuppressant regimen who were followed up after transplantation participated in this study. Data was collected through a self-reported questionnaire survey (medication adherence, SE, and quality of life) and medical record review.
RESULTS: Low adherence in the immunosuppressant group was associated with longer time since KT, less comorbidity (<3), and a higher rehospitalization rate. Low adherence among KT recipients showed significantly greater overall symptom occurrence (P = .001) and symptom distress (P = .002) levels than patients with high or medium adherence after adjusting for a number of covariates. The most common symptom both in terms of occurrence (96.4%) and distress (91.1%) among poorly adherent KT recipients was tiredness.
CONCLUSION: Low adherence to an immunosuppressant regimen was significantly associated with high SE among KT recipients. Strategies to decrease immunosuppressant-related SE are needed to improve adherence to immunosuppressants.