Self‐reported non‐adherence to immunosuppressive medication in adult lung transplant recipients—A single‐center cross‐sectional study

Abstract

Background: Non‐adherence to immunosuppressive treatment following solid organ transplantation is common and often associated with poorer outcomes. Non‐adherence is difficult to assess, and barriers to adherence in lung transplant (LTx) recipients remain to be elucidated. Methods: A single‐center cross‐sectional observational study of all LTx recipients attending our department between 07/2013 and 05/2014 was performed. Non‐adherence was assessed using patient self‐reporting, including Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS) along with healthcare worker (HCW) judgment and reasons for non‐adherence by the Immunosuppressive Therapy Barriers Scale. Results: A total of 138/504 patients (27.4%) self‐reported non‐adherence to immunosuppressive medication. HCW scored 96/504 patients (19.1%) as poorly adherent. Self‐reported non‐adherence increased with increasing interval after transplantation. The main reason for non‐adherence was punctuality (75%), with only 11% reporting drug holidays. Explanations for non‐adherence were primarily related to self‐organization and difficulties incorporating medication into daily routine. There were no significant differences in medication knowledge or variation in trough levels. Conclusions: This study confirms that non‐adherence in LTx recipients is frequent according to self‐report. Barriers are self‐organization and difficulties incorporating medication into daily routine. Social and behavioral support is needed to overcome non‐adherence. (ClinicalTrials.gov number: NCT01889017).