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Behavioral measures to reduce non-adherence in renal transplant recipients: a prospective randomized controlled trial
Márcia Fátima Faraldo Martinez Garcia1, Ariane Moyses Bravin1, Paula Dalsoglio Garcia1
1Department of Internal Medicine - UNESP, Univ Estadual Paulista, Rubião Jr, S/N, Botucatu, SP, 18.618-970, Brazil.
Purpose:
Solid-organ transplant recipients present a high rate of non-adherence to drug treatment. Few interventional studies have included approaches aimed at increasing adherence. The objective of this study was to evaluate the impact of an educational and behavioral strategy on treatment adherence of kidney transplant recipients.
Methods:
In a randomized prospective study, incident renal transplant patients (n = 111) were divided into two groups: control group (received usual transplant patient education) and treatment group (usual transplant patient education plus ten additional weekly 30-min education/counseling sessions about immunosuppressive drugs and behavioral changes). Treatment adherence was assessed using ITAS adherence questionnaire after 3 months. Renal function at 3, 6, and 12 months, and the incidence of transplant rejection were evaluated.
Results:
The non-adherence rates were 46.4 and 14.5 % in the control and treatment groups (p = 0.001), respectively. The relative risk for non-adherence was 2.59 times (CI 1.38-4.88) higher in the control group. Multivariate analysis demonstrated a 5.84 times (CI 1.8-18.8, p = 0.003) higher risk of non-adherence in the control group. There were no differences in renal function and rejection rates between groups.
Conclusions:
A behavioral and educational strategy addressing the patient's perceptions and knowledge about the anti-rejection drugs significantly improved the short-term adherence to immunosuppressive therapy.
Insights
A new educational and behavioral strategy significantly improved medication adherence in kidney transplant recipients. This approach addressed patient knowledge and perceptions of immunosuppressive drugs, reducing non-adherence rates.
Area of Science:
- Transplantation medicine
- Pharmacology
- Behavioral science
Background:
- Solid-organ transplant recipients often struggle with medication adherence.
- Few studies have investigated interventions to improve adherence in this population.
Purpose of the Study:
- To assess the effectiveness of an educational and behavioral intervention on medication adherence in kidney transplant recipients.
Main Methods:
- A randomized prospective study involved 111 incident renal transplant patients.
- The treatment group received standard education plus weekly counseling sessions on immunosuppressants and behavioral changes.
- Adherence was measured using the ITAS questionnaire after 3 months.
Main Results:
- Non-adherence rates were 46.4% in the control group versus 14.5% in the treatment group (p=0.001).
- The control group had a 2.59 times higher relative risk of non-adherence.
- Multivariate analysis showed a 5.84 times higher risk of non-adherence in the control group.
Conclusions:
- The educational and behavioral strategy substantially enhanced short-term adherence to immunosuppressive therapy.
- This intervention effectively improved patient knowledge and perceptions regarding anti-rejection medications.
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