Cited by 424Medication Adherence and ComplianceRenal Transplantation Outcomes and TreatmentsDialysis and Renal Disease Management

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Prevalence, consequences, and determinants of nonadherence in adult renal transplant patients: a literature review

Denhaerynck, Kris, Dobbels, Fabienne, Cleemput, Irina, Desmyttere, Ariane, Schafer-Keller, Petra, Schaub, Stefan, De Geest, Sabina·2005·Transplant International

DOI 10.1111/j.1432-2277.2005.00176.x

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Abstract

This literature review summarizes the evidence on the prevalence, determinants, clinical and economic consequences of nonadherence with immunosuppressive drugs in renal transplant patients. A literature search yielded 38 articles measuring nonadherence by self-report, collateral report, assay, refill prescriptions or electronic monitoring. The weighted mean prevalence of self-reported nonadherence was 28%. Nonadherence is associated with poor clinical outcomes, contributing to 20% of late acute rejection episodes and 16% of the graft losses (weighted means). In addition, nonadherence results in lower lifetime costs because of shorter survival, yet also in a lower number of quality adjusted life years. Consistent determinants of nonadherence were younger age, social isolation, and cognitions (e.g. low self-efficacy, certain health beliefs). Determinants concerning the health care system/team seem to be under-investigated. Because the evidence summarized in this review is based on older immunosuppressive regimens, further research should focus on prevalence, determinants and consequences of nonadherence with newer immunosuppressive regimens.

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Authors: Denhaerynck, K., Dobbels, F., Cleemput, I., Desmyttere, A., Schafer-Keller, P., Schaub, S., & De Geest, S.
Affiliations: University of Basel (CH)
KU Leuven (BE)
Belgian Health Care Knowledge Centre (KCE) (BE)
University Hospital of Basel (CH)
ORCID: Denhaerynck, Kris
Dobbels, Fabienne
Cleemput, Irina
Schaub, Stefan
Venue: Transplant International
Publisher: Frontiers Media SA
Published: 2005-10
Volume: 18
Issue: 10
Pages: 1121-1133
ISSN: 0934-0874 (ISSN-L)
1432-2277
DOI: 10.1111/j.1432-2277.2005.00176.x
OpenAlex: W2151433573
Cited by: 424
References: 70
Citations by year: 2026: 10 · 2025: 11 · 2024: 15 · 2023: 18 · 2022: 28 · 2021: 33 · 2020: 25 · 2019: 30 · 2018: 32 · 2017: 29 · 2016: 26 · 2015: 25 · 2014: 26 · 2013: 15 · 2012: 24
FWCI: 0.57
Type: journal article
Language: en
Open access: closed
Licence: doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 3622 d)
Locations: Transplant International (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
Keywords: medication non-adherence, kidney transplantation, immunosuppressants, graft loss, acute rejection, economic burden, quality-adjusted life years, self-efficacy, health beliefs, social isolation
MeSH terms: Adult, Female, Graft Rejection, Humans, Immunosuppressive Agents, Male, Middle Aged, Prevalence, Kidney Transplantation, Treatment Refusal, Treatment Outcome

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Prevalence, consequences, and determinants of nonadherence in adult renal transplant patients: a literature review

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