Risk Factors for Non-Adherence to Medication for Liver Transplant Patients: An Umbrella Review

Area of Science:

• Medical Science
• Transplantation Medicine
• Pharmacology

Background:

• Liver transplantation (LT) is a vital treatment for end-stage liver disease.
• Medication adherence in LT recipients is critical for long-term graft survival and patient outcomes.
• Non-adherence poses significant risks, including graft failure, mortality, and reduced quality of life.

Purpose of the Study:

• To systematically identify and categorize risk factors associated with non-adherence to immunosuppressive medication in liver transplant patients.
• To synthesize evidence from published literature to understand predictors of adherence and non-adherence.

Main Methods:

• An umbrella review methodology was employed, adhering to PRISMA guidelines.
• Eleven relevant articles were systematically selected and analyzed.
• Risk factors for non-adherence were classified using the World Health Organization's (WHO) framework.

Main Results:

• Non-adherence factors were identified and grouped into five main categories: sociodemographic, patient-related, treatment-related, condition-related, and health system-related.
• These factors directly or indirectly influence medication adherence in liver transplant recipients.
• The identified factors serve as predictors for both adherence and non-adherence.

Conclusions:

• Sociodemographic, patient, treatment, condition, and health system factors are key predictors of medication adherence in liver transplant patients.
• This classification aids clinicians in identifying at-risk patients and developing targeted interventions.
• Understanding these predictors can inform the design of tools to improve adherence post-transplantation.