Medication compliance in renal transplant patients during the Great East Japan Earthquake

Oral immunosuppressant suspension induces renal graft dysfunction in renal transplant patients. After the Great East Japan Earthquake, not only were drugs lost in the tsunami, but visiting hospitals became difficult owing to information and transportation network disruption. We investigated medication compliance in renal transplant patients and actions taken immediately after the earthquake.

We included 315 patients who were visiting our outpatient department as of March 11, 2011, from June to August 2011. Information was collected from questionnaires, medical records, and outpatient diaries.

The questionnaire collection rate was 93%, with valid replies from 296 patients. One hundred eighty-five patients (62%) had stockpiled oral medications before the earthquake; of these, 131 (44%) always carried medications with them. Forty-five patients (16%) had difficulties with continuing oral immunosuppressants after the earthquake (supply delay, 29 patients; drugs lost in tsunami, 9; others, 10). Of these 48, oral medication was suspended in 18 for 3 days at maximum. As to outpatient prescriptions, out-of-hospital prescriptions were sent by fax to 17 patients, prescription drugs were sent from our hospital by mail or home delivery services to 11, and prescriptions were given to 13 who visited other hospitals. Because of the difficulty in requesting prescriptions from disaster base hospitals, drugs prescribed at our hospital were delivered to 3 severely damaged institutions for patients living in surrounding areas. After the earthquake, our usual self-management guidance proved effective.

Further examination of the infrastructure for communicating with patients and supplying drugs is needed.