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Published on: April 12, 2021
Psychological and Cognitive Factors Associated With Nonadherence to Post-Cardiac Transplant Treatment
Rosemary Inácio Viana1,2, Eduardo Remor3, Lívia Adams Goldraich1
1Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Progress in Transplantation (Aliso Viejo, Calif.)
|July 14, 2026
Summary
Anxiety and perceived barriers significantly impact heart transplant patients' adherence to immunosuppressant medication. Early screening for psychological factors is crucial for improving post-transplant treatment outcomes and self-care.
Area of Science:
- Cardiology
- Psychology
- Pharmacology
Background:
- Treatment nonadherence is a significant challenge in post-heart transplantation care.
- Understanding factors influencing adherence is critical for patient outcomes.
Purpose of the Study:
- To investigate the association between psychological indicators (anxiety, depression), cognitive function, and treatment nonadherence in heart transplant recipients.
- To identify patient-level perceived barriers to self-care and their impact on medication adherence.
Main Methods:
- A cross-sectional study involving 74 heart transplant patients (mean age 54.1 years) assessed at least 6 months post-transplant.
- Utilized GAD-7 for anxiety, PHQ-9 for depression, MoCA-B for cognitive screening, and BAASIS for medication adherence.
- Assessed perceived barriers to self-care using a dedicated inventory.
Main Results:
- Nearly 60% of participants exhibited nonadherence behavior in the past month.
- Anxiety symptoms (GAD-7) and perceived barriers to self-care were significantly associated with nonadherence.
- Mild cognitive impairment was present in 10.8% but not linked to nonadherence.
Conclusions:
- Psychological factors, particularly anxiety and perceived barriers, are key contributors to nonadherence in heart transplant patients.
- Routine screening for psychological distress and self-care barriers is recommended post-transplant.
- Proactive support for patients' psychological well-being is essential for improving treatment adherence and long-term graft survival.
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