Medication Nonadherence After Lung Transplantation in Adult Recipients
Open accessAbstract
Background Our objective was to identify potential avenues for resource allocation and patient advocacy to improve outcomes by evaluating the association between recipient sociodemographic and patient characteristics and medication nonadherence after lung transplantation. Methods States US adult, lung-only transplantations per the United Network for Organ Sharing database were analyzed from October 1996 through December 2006, based on the period during which nonadherence information was recorded. Generalized linear models were used to determine the association of demographic, disease, and transplantation center characteristics with early nonadherence (defined as within the first year after transplantation) as well as late nonadherence (years 2 to 4 after transplantation). Outcomes comparing adherent and nonadherent patients were also evaluated. Results Patients (n = 7,284) were included for analysis. Early and late nonadherence rates were 3.1% and 10.6%, respectively. Factors associated with early nonadherence were Medicaid insurance compared with private insurance (adjusted odds ratio [AOR] 2.45, 95% confidence interval [CI]: 1.16 to 5.15), and black race (AOR 2.38, 95% CI: 1.08 to 5.25). Medicaid insurance and black race were also associated with late nonadherence (AOR 2.38, 95% CI: 1.51 to 3.73 and OR 1.73, 95% CI: 1.04 to 2.89, respectively), as were age 18 to 20 years (AOR 3.41, 95% CI: 1.29 to 8.99) and grade school or lower education (AOR 1.88, 95% CI: 1.05 to 3.35). Early and late nonadherence were both associated with significantly shorter unadjusted survival (p < 0.001). Conclusions Identifying patients at risk of nonadherence may enable resource allocation and patient advocacy to improve outcomes.
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Recently, non-adherence with immunosuppressive medication was associated with impaired survival of lung transplant patients in a large US registry analysis.
“Recently, non-adherence with immunosuppressive medication was associated with impaired survival of lung transplant patients in a large US registry analysis[11].”
From Adherence is associated with a favorable outcome after lung transplantation (2019) · cites this paper as [11]
In a recent registry analysis of 7,284 LTx recipients, 4-year non-adherence regarding immunosuppression was found in 10.6% of patients and was associated with shorter unadjusted survival.
“In a recent registry analysis of 7,284 LTx recipients, 4-year non-adherence regarding immunosuppression was found in 10.6% of patients and was associated with shorter unadjusted survival[11].”
From Adherence is associated with a favorable outcome after lung transplantation (2019) · cites this paper as [11]
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- Authors
- Castleberry, A. W., Bishawi, M., Worni, M., Erhunmwunsee, L., Speicher, P. J., Osho, A. A., Snyder, L. D., & Hartwig, M. G.
- Affiliations
- Duke University (US)
- University of Bern (CH)
- Massachusetts General Hospital (US)
- Duke Medical Center (US)
- Corresponding author
- Castleberry, Anthony W.
- ORCID
- Venue
- The Annals of Thoracic Surgery
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 103
- Issue
- 1
- Pages
- 274-280
- ISSN
- 0003-4975 (ISSN-L)
- PMC
- PMC5182128
- OpenAlex
- W2520133918
- Cited by
- 39
- References
- 41
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 1 · 2023: 8 · 2022: 5 · 2021: 1 · 2020: 4 · 2019: 3 · 2018: 9 · 2017: 2
- FWCI
- 5.69
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Annals of Thoracic Surgery (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion, cc-by-nc-nd)
- Open Access CRIS of the University of Bern
- Funders
- Health Resources and Services Administration
- Department of Health
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Keywords
- medication non-adherence, lung transplantation, sociodemographic factors, Medicaid, racial disparities, low educational attainment, young adult transplant recipients, post-transplant survival, patient advocacy, transplant outcomes
- MeSH terms
- Adult, Female, Follow-Up Studies, Graft Rejection, Medicare, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Time Factors, United States, Lung Transplantation, Medication Adherence, Young Adult, Transplant Recipients
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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