Correlates of noncompliance among renal transplant recipients

The purpose of this study was to identify variables that are associated with noncompliance among adult renal transplant recipients, including demographic characteristics, transplant-related variables, and psychosocial factors. The measurement of noncompliance was improved by assessing noncompliant behaviors (i.e., noncompliance with medications and the follow-up regimen) prior to the onset of complications and/or graft loss and by measuring compliance as a continuous rather than dichotomous variable. Two-hundred-and-forty-one renal transplant recipients completed the Beck Depression Inventory, the anxiety and hostility subscales of the Brief Symptom Inventory, the Multidimensional Health Locus of Control Scale, the Inventory of Socially Supportive Behaviors, the Coping Strategies Inventory, a measure of transplant-related stressors, and self-report measures of compliance with medications and the follow-up regimen. Approximately half of our sample reported at least some degree of noncompliance. Recipients who were younger, female, unmarried, retransplanted, and with lower incomes tended to be noncompliant with medications (all p's < 0.05). Recipients who were unmarried, low income, not insulin-dependent, and with a longer time since transplant tended to be noncompliant with the follow-up regimen. In addition, recipients who reported higher stress and more depression, who coped with stress by using avoidant coping strategies, and who believed that health outcomes are beyond their control were less compliant with both medications and follow-up (all p's < 0.05). Regression analyses revealed that stress was the strongest predictor of both medication and follow-up compliance.