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Adherence to and Acceptance of Once-Daily Tacrolimus After Kidney and Liver Transplant: Results From OSIRIS, a French
Elisabeth Cassuto1, Georges P Pageaux, Diego Cantarovich
11 Hôpital Pasteur, Nice, France.2 Hôpital Saint Eloi, Montpellier, France.3 CHU Nantes, Nantes, France.4 Hôpital Rangueil, Toulouse, France.5 Hôpital Necker, Paris, France.6 Hôpital de Jour, Villejuif, France.7 Groupe Hospitalier Henri Mondor, Créteil, France.8 CHU Bordeaux, Bordeaux, France.9 Hôpital Europeen Georges Pompidou, Paris, France.10 CHU Amiens-Picardie, Amiens, France.11 Mapi, Lyon, France.12 Hôpital Claude Huriez, Lille, France.13 Hôpital d'adultes de Brabois, Vandoeuvre Les Nancy, France.
Background:
Adherence to immunosuppressive treatments is a major concern in transplanted patients.
Methods:
This 6-month French observational, longitudinal, prospective study aimed to assess patient adherence to and acceptance of once-daily tacrolimus (Advagraf) initiation in kidney and liver transplant recipients. Data from 1106 patients initiating once-daily tacrolimus during posttransplant follow-up were analyzed. Adherence and acceptance were assessed using self-administered questionnaires at inclusion and at 3 and 6 months.
Results:
Mean age was 52.4 ± 13.2 years, 61.5% were men. For 94.9% of patients, once-daily tacrolimus was prescribed after switching from twice-daily tacrolimus. At inclusion, 20.9% of patients reported good treatment adherence, 72.0% minor nonadherence, and 7.1% were nonadherent. Mean general acceptance score (range, 0-100) was 77.7 (±24.7). At 3 months, adherence was improved in 21.1%, unchanged in 69.2%, and worsened in 9.7% of patients. Mean general acceptance score was 75.4 (±26.5). General acceptance score was improved in 28.0%, unchanged in 39.4%, and worsened in 32.7% of patients. At 6 months, similar changes in adherence and acceptance were observed. Higher general acceptance score at month 3 was significantly associated with better adherence at month 6.
Conclusions:
Conversion to once-daily tacrolimus led to an improved rate of adherence at month 3 in more than 20% of patients and a worsened rate of adherence in less than 10% of patients.