BACKGROUND: Non-adherence to immunosuppressive treatment following solid organ transplantation is common and often associated with poorer outcomes. Non-adherence is difficult to assess, and barriers to adherence in lung transplant (LTx) recipients remain to be elucidated. METHODS: A single-center cross-sectional observational study of all LTx recipients attending our department between 07/2013 and 05/2014 was performed. Non-adherence was assessed using patient self-reporting, including Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS) along with healthcare worker (HCW) judgment and reasons for non-adherence by the Immunosuppressive Therapy Barriers Scale. RESULTS: A total of 138/504 patients (27.4%) self-reported non-adherence to immunosuppressive medication. HCW scored 96/504 patients (19.1%) as poorly adherent. Self-reported non-adherence increased with increasing interval after transplantation. The main reason for non-adherence was punctuality (75%), with only 11% reporting drug holidays. Explanations for non-adherence were primarily related to self-organization and difficulties incorporating medication into daily routine. There were no significant differences in medication knowledge or variation in trough levels. CONCLUSIONS: This study confirms that non-adherence in LTx recipients is frequent according to self-report. Barriers are self-organization and difficulties incorporating medication into daily routine. Social and behavioral support is needed to overcome non-adherence. (ClinicalTrials.gov number: NCT01889017).
- Drick, N.
- Seeliger, B.
- Fuge, J.
- Tudorache, I.
- Greer, M.
- Welte, T.
- Haverich, A.
- Gottlieb, J.
Keywords
- immunosuppressant
- lung disease
- patient education
