Postrenal transplant compliance from the perspective of African-Americans, Hispanic-Americans, and Anglo-Americans

Medication compliance by patients is a subject that has attracted attention because it has been identified as the third leading cause of renal graft loss. The purpose of this study was to gather specific information about renal-transplant recipients' cognitions, emotions, and behaviors during the postrenal transplant compliance process. Data from 519 renal transplant patients were collected through mailed surveys; chart audits were conducted for 397 patients in the sample. Findings revealed that 96 (18%) of the transplant recipients had been noncompliant with immunosuppressive medications. Factors related to noncompliance included being away from home, length of time since transplant, age, gender, and ethnicity, as well as patients' beliefs regarding how long posttransplant symptoms would persist and their beliefs about the effectiveness of immunosuppressive medications. Of particular interest were the findings related to compliance by African-American patients, which challenge conventional thinking. Implications for assessing patient compliance, patient education, and further research are discussed.