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A Retrospective Analysis of Immunosuppression Compliance, Dose Reduction and Discontinuation in Kidney Transplant Recipients
Open accessAbstract
We describe factors associated with poor compliance and dose reductions and examine the relative impact of compliance, dose reduction and discontinuation on graft outcome. Medicare claims for MMF in 7062 deceased donor renal recipients with at least 1 year of graft function were used to calculate compliance and dose reductions. Compliance was modeled using medication possession ratio to define quartiles for poor, low, medium and high compliance. The relative impact of compliance, dose reduction and discontinuation on graft outcome was assessed with Cox proportional hazards. Pediatric (Age 0-18, Odds ratio = 1.71, 95% CI 1.11-2.63, p = 0.014) and adolescent recipients (19-24, 1.57, 1.23-2.00, p < 0.001) were more likely poorly compliant compared to adults age 25-44. Poor compliance was also associated with physical limitations, hypertension, delayed graft function, rejection, infection and GI conditions. Poor (1.43, 1.11-1.84, p = 0.005) and low (1.46, 1.13-1.88, p = 0.004) compliance was associated with an increased hazard of graft loss as was >50% dose reduction (1.69, 1.15-2.50, p = 0.008) and discontinuation (8.34, 6.85-10.2, p < 0.001). Medication possession ratios lower than the 3-year mean were associated with an increased risk of graft loss. These results may indicate that interventions to improve compliance among kidney transplant recipients should strive for high rather than discourage low compliance.
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“Other groups used the discrepancy between immunosuppressant dosages and prescription refills or data from health insurances for the assessment of adherence[35,36].”
From Adherence is associated with a favorable outcome after lung transplantation (2019) · cites this paper as [36]
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Diabetes Mellitus after Kidney Transplantation in the United States
Kasiske, B. L., Snyder, J. J., Gilbertson, D. T., & Matas, A. J. (2003) · American Journal of Transplantation · doi:10.1034/j.1600-6143.2003.00010.x · Cited by 1,286
Strategies to Improve Long-Term Outcomes after Renal Transplantation
Pascual, M. A., Theruvath, T. P., Kawai, T., TOLKOFF-RUBIN, N. E., & Cosimi, A. B. (2002) · New England Journal of Medicine · doi:10.1056/nejmra011295 · Cited by 838 · cited 1×
“MMF has been shown to be an effective adjunct to calcineurin inhibitor (CNI) regimens for preventing acute (27) and chronic rejection (28,29) of renal allografts, and has become the standard adjunct immunosuppressant at most transplant centers in the United States (30).”
BackgroundA Checklist for Medication Compliance and Persistence Studies Using Retrospective Databases
Peterson, A. M., Nau, D. P., Cramer, J. A., Benner, J., Gwadry-Sridhar, F. H., & Nichol, M. B. (2006) · Value in Health · doi:10.1111/j.1524-4733.2006.00139.x · Cited by 638 · cited 3×
“MPR has been used to assess compliance to anti-hyperglycemic, lipid-lowering and anti-hypertensive therapies (13).”
BackgroundMethodInfluentialButler, J. A., Roderick, P., Mullee, M., Mason, J. C., & Peveler, R. (2004) · Transplantation · doi:10.1097/01.tp.0000110408.83054.88 · Cited by 545
Estimating medication persistency using administrative claims data.
Sikka, R., Xia, F., & Aubert, R. E. (2005) · PubMed · Cited by 456
Denhaerynck, K., Dobbels, F., Cleemput, I., Desmyttere, A., Schafer-Keller, P., Schaub, S., & De Geest, S. (2005) · Transplant International · doi:10.1111/j.1432-2277.2005.00176.x · Cited by 424 · cited 9×
“Most other studies have either used rejection as an endpoint or estimated the percentage of graft losses attributable to poor compliance (2,11).”
BackgroundMethodInfluential
Cited by
Sorted by citations
Transplant Outcomes and Economic Costs Associated with Patient Noncompliance to Immunosuppression
Pinsky, B. W., Takemoto, S., Lentine, K. L., Burroughs, T. E., Schnitzler, M. A., & Salvalaggio, P. R. D. O. (2009) · American Journal of Transplantation · doi:10.1111/j.1600-6143.2009.02798.x · Cited by 331
“Using this methodology, we recently found that poor compliance with MMF was associated with 43–46% increased risk of graft failure (14).”
MethodSelf-citationDobbels, F., Ruppar, T. M., Geest, S. D., Decorte, A., Damme‐Lombaerts, R. V., & Fine, R. Ν. (2009) · Pediatric Transplantation · doi:10.1111/j.1399-3046.2010.01299.x · Cited by 306
“2007 (19) USA N = 40 (adolescents out of larger study) Retrospective analysis Prescription refill Medication possession ratio (MPR) over a 1–3-year time period (divided in quartiles using time dependent analysis): high adherence >98% MPR; medium between 81 and 98%, low between 69 and 81%; and poor: <69% 44% Adherence…”
BackgroundNonadherence Consensus Conference Summary Report
Fine, R. Ν., Becker, Y. T., Geest, S. D., Eisen, H. J., Ettenger, R. B., Evans, R., Rudow, D. L., McKay, D. B., Neu, A. M., Nevins, T. E., et al. (2008) · American Journal of Transplantation · doi:10.1111/j.1600-6143.2008.02495.x · Cited by 297
“<95% adherence to the immunosuppressive regimen) are sufficient to result in poor outcomes (10,14).”
BackgroundInterventions to improve medication-adherence after transplantation: a systematic review
Bleser, L. D., Matteson, M., Dobbels, F., Russell, C. L., & Geest, S. D. (2009) · Transplant International · doi:10.1111/j.1432-2277.2009.00881.x · Cited by 248
“2 Counseling/behavioral interventions targeted, shaped, and/or reinforced behavior, empowered patients to participate in their care, positively changed a patient’s skill level or normal routine [3,7,8].”
BackgroundMethodResultInfluentialImproved Adherence to Tacrolimus Once-Daily Formulation in Renal Recipients
Kuypers, D. R. J., Peeters, P. C., Sennesael, J. J., Kianda, M. N., Vrijens, B., Kristanto, P., Dobbels, F., Vanrenterghem, Y. F. C., & Kanaan, N. (2012) · Transplantation · doi:10.1097/tp.0b013e3182725532 · Cited by 228
Dobbels, F., Berben, L., De Geest, S., Drent, G., Lennerling, A., Whittaker, C., & Kugler, C. (2010) · Transplantation · doi:10.1097/tp.0b013e3181e346cd · Cited by 220
“Finally, transplant professionals require good quality instruments that do not pose an extra burden in terms of workload and time investment (7, 9) and that are reliable, valid, and responsive to change.”
BackgroundPharmacology and toxicology of mycophenolate in organ transplant recipients: an update
Staatz, C. E., & Tett, S. E. (2014) · Archives of Toxicology · doi:10.1007/s00204-014-1247-1 · Cited by 206
“Nonadherence was reported to be similar between the groups (16 % for African American recipients, compared to 9 %), but it was not stated how adherence was assessed and it is difficult to measure this accurately (Jensen et al. 2011; Takemoto et al. 2007).”
BackgroundMcGillicuddy, J. W., Gregoski, M. J., Weiland, A. K., Rock, R. A., Brunner-Jackson, B. M., Patel, S. K., Thomas, B. S., Taber, D. J., Chavin, K. D., Baliga, P. K., et al. (2013) · JMIR Research Protocols · doi:10.2196/resprot.2633 · Cited by 194
“While the risk with non-adherence is a continuum, even very small degrees of non-adherence confer a significantly increased risk of graft rejection or graft loss [16,18].”
BackgroundKrämer, B. K., Charpentier, B., Bäckman, L., Junior, H. T. S., Mondragón-Ramírez, G., Cassuto, É., Mourad, G., Solà, R., Rigotti, P., & Mirete, J. O. (2010) · American Journal of Transplantation · doi:10.1111/j.1600-6143.2010.03256.x · Cited by 168
Schäfer-Keller, P., Steiger, J., Bock, A., Denhaerynck, K., & De Geest, S. (2008) · American Journal of Transplantation · doi:10.1111/j.1600-6143.2007.02127.x · Cited by 198
“Evidence from previous research, showing that minimal deviations from the dosing schedule were associated with increased risk of late acute rejection episodes in adult heart (42) and renal (2,30) transplant recipients, supports this stringent cut-off.”
MethodResultLow, J. K., Williams, A. F., Manias, E., & Crawford, K. (2014) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfu204 · Cited by 158
“It is therefore evident that non-adherence not only increases the risk of hospitalization [26] but also causes poor long-term kidney outcomes [37], which negatively impact on the patient’s health and quality of life.”
BackgroundMedication non‐adherence in the adolescent renal transplant recipient: A clinician's viewpoint*
Rianthavorn, P., & Ettenger, R. B. (2005) · Pediatric Transplantation · doi:10.1111/j.1399-3046.2005.00358.x · Cited by 147
Leino, A. D., King, E. C., Jiang, W., Vinks, A. A. T. M. M., Klawitter, J., Christians, U., Woodle, E. S., Alloway, R. R., & Rohan, J. M. (2018) · American Journal of Transplantation · doi:10.1111/ajt.15199 · Cited by 123
Chisholm‐Burns, M. A., Spivey, C. A., Zivin, J. G., Lee, J. K., Sredzinski, E., & Tolley, E. A. (2013) · American Journal of Transplantation · doi:10.1111/ajt.12341 · Cited by 118
“However, an autoregressive covariance structure (AR(1)) was incorporated into themodel to account for the influence of previous behavior”
BackgroundMethodWeng, F. L., Chandwani, S., Kurtyka, K., Zacker, C., Chisholm‐Burns, M. A., & Demissie, K. (2013) · BMC Nephrology · doi:10.1186/1471-2369-14-261 · Cited by 112
“clinicians’ collateral reports [30,31], serum assays for immunosuppressive medication concentrations [32-34], pill counts, and prescription refill and claims records [35].”
BackgroundPsychopathological aspects of kidney transplantation: Efficacy of a multidisciplinary team
Pasquale, C. D. (2014) · World Journal of Transplantation · doi:10.5500/wjt.v4.i4.267 · Cited by 101
Psychosocial Predictors of Mortality Following Lung Transplantation
Smith, P. J., Blumenthal, J. A., Trulock, E. P., Freedland, K. E., Carney, R. M., Davis, R. D., Hoffman, B. M., & Palmer, S. M. (2015) · American Journal of Transplantation · doi:10.1111/ajt.13447 · Cited by 93
Prihodová, L., Nagyová, I., Rosenberger, J., Majerníková, M., Roland, R., Groothoff, J. W., & van Dijk, J. P. (2014) · Journal of Advanced Nursing · doi:10.1111/jan.12447 · Cited by 89
Dobbels, F., Decorte, A., Roskams, A., & Damme‐Lombaerts, R. V. (2009) · Pediatric Transplantation · doi:10.1111/j.1399-3046.2009.01197.x · Cited by 88
“Limited evidence shows that a taking adherence of <98% is already sufficient to be associated with late acute rejections (13) and graft loss (14).”
Schmid‐Mohler, G., Thut, M. P., Wuthrich, R. P., Denhaerynck, K., & Geest, S. D. (2009) · Clinical Transplantation · doi:10.1111/j.1399-0012.2009.01056.x · Cited by 87
Factors Predictive of Medication Nonadherence After Renal Transplantation
Couzi, L., Moulin, B., Morin, M.-P., Albano, L., Godin, M., Barrou, B., Alamartine, É., Morélon, E., Girardot-Seguin, S., Mendes, L. P., et al. (2012) · Transplantation · doi:10.1097/tp.0b013e318271d7c1 · Cited by 83
“NA to immunosuppressive therapy is associated with a significant increase in serum creatinine level over time (5), an increased number of late acute rejections (5Y8), increased risk of graft loss (2, 7, 9, 10), and higher treatment costs (11).”
BackgroundMedication-taking among adult renal transplant recipients: barriers and strategies
Gordon, E. J., Gallant, M. P., Sehgal, A. R., Conti, D., & Siminoff, L. A. (2009) · Transplant International · doi:10.1111/j.1432-2277.2008.00827.x · Cited by 80
“Medication nonadherence is common, occurring in 5% to more than 45% of renal transplant recipients [5,11,12], and adherence declines over time [13].”
De Bleser, L., Dobbels, F., Berben, L., Vanhaecke, J., Verleden, G., Nevens, F., & De Geest, S. (2011) · Transplant International · doi:10.1111/j.1432-2277.2011.01296.x · Cited by 89
“First, the majority use a single NA measurement method; in the absence of a gold standard to assess medication NA, recent studies recommend a combination of assessment methods to enhance sensitivity [4,5].”
MethodAgid, O., Foussias, G., & Remington, G. J. (2010) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2010.499125 · Cited by 80
“Other reports involving chronic medical conditions such as diabetes, chronic obstructive pulmonary disease (COPD) and chronic kidney disease estimate medication nonadherence to be in the range of 40 -- 60% [17-19].”
BackgroundLerret, S. M., & Weiss, M. (2011) · Pediatric Transplantation · doi:10.1111/j.1399-3046.2011.01536.x · Cited by 74
Graft Failure Due to Noncompliance Among 628 Kidney Transplant Recipients With Long-term Follow-up
Gaynor, J. J., Ciancio, G., Guerra, G., Sageshima, J., Hanson, L., Roth, D., Chen, L., Kupin, W. L., Mattiazzi, A. D., Tueros, L., et al. (2014) · Transplantation · doi:10.1097/01.tp.0000438199.76531.4a · Cited by 73
Joost, R., Dörje, F., Schwitulla, J., Eckardt, K., & Hugo, C. (2014) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfu207 · Cited by 72
“While recent literature demands adherence levels of up to 95% [11, 50], it remains the major question, how this can be achieved with justifiable effort.”
Backgroundvan Gelder, T., Meziyerh, S., Swen, J. J., de Vries, A. P. J., & Moes, D. J. A. R. (2020) · Frontiers in Pharmacology · doi:10.3389/fphar.2020.01142 · Cited by 71
“Furthermore, non-adherence is a strong predictor for poor outcome and is related to development of donor specific antibodies and a higher risk of rejection (Takemoto et al., 2007).”
BackgroundSocial support and immunosuppressant therapy adherence among adult renal transplant recipients
Chisholm‐Burns, M. A., Spivey, C. A., & Wilks, S. E. (2009) · Clinical Transplantation · doi:10.1111/j.1399-0012.2009.01060.x · Cited by 72
Morales, J. M., Varó, E., & Lázaro, P. (2011) · Clinical Transplantation · doi:10.1111/j.1399-0012.2011.01544.x · Cited by 70
Spivey, C. A., Chisholm‐Burns, M. A., Damadzadeh, B., & Billheimer, D. D. (2013) · Clinical Transplantation · doi:10.1111/ctr.12283 · Cited by 70
Gordon, E. J., PROHASKA, T. R., Gallant, M. P., Sehgal, A. R., Strogatz, D. S., Yucel, R. M., Conti, D., & Siminoff, L. A. (2009) · Transplant International · doi:10.1111/j.1432-2277.2009.00917.x · Cited by 68
“The adverse effects on graft function of medication nonadherence [10,11] are well documented, as is cigarette smoking [12,13].”
BackgroundVanhove, T., Kuypers, D. R. J., Claes, K. J., Evenepoel, P., Meijers, B. K. I., Naesens, M., Vanrenterghem, Y. F. C., Cornelis, T., & Bammens, B. (2013) · Transplant International · doi:10.1111/tri.12133 · Cited by 66
Dharancy, S., Giral, M., Tétaz, R., Fatras, M., Dubel, L., & Pageaux, G. (2012) · Clinical Transplantation · doi:10.1111/j.1399-0012.2012.01652.x · Cited by 65
Bunnapradist, S., & Ambühl, P. M. (2008) · Clinical Transplantation · doi:10.1111/j.1399-0012.2008.00892.x · Cited by 64
“Interestingly, one study has investigated the effect of GI complications on patients adherence to the prescribed MMF regimen (20).”
BackgroundSelf-citationJaber, J. J., Feustel, P. J., Elbahloul, O., Conti, A. D., Gallichio, M. H., & Conti, D. J. (2006) · Clinical Transplantation · doi:10.1111/j.1399-0012.2006.00613.x · Cited by 62
Sustainability of Improvements in Medication Adherence through a Mobile Health Intervention
McGillicuddy, J. W., Taber, D. J., Mueller, M., Patel, S. K., Baliga, P. K., Chavin, K. D., Sox, L. R., Favela, A. P., Brunner-Jackson, B. M., & Treiber, F. A. (2015) · Progress in Transplantation · doi:10.7182/pit2015975 · Cited by 60
“Exclusion criteria included (1) inability to self-administer medications, (2) inability to measure own blood pressure, (3) inability to use a mobile phone, (4) history of psychiatric illness or substance abuse, (5) pregnant, lactating, or intending to become pregnant during the trial, (6) participant in another study,…”
Clinical consequences of non adherence to immunosuppressive medication in kidney transplant patients
Denhaerynck, K., Burkhalter, F., Schäfer‐Keller, P., Steiger, J. U., Bock, A., & Geest, S. D. (2009) · Transplant International · doi:10.1111/j.1432-2277.2008.00820.x · Cited by 62
“[12], who found a relationship between non adherence and poor outcomes in a mycophenolate mofetil-based regimen.”
BackgroundBiological and psychological differences in the child and adolescent transplant recipient
Hsu, D. T. (2005) · Pediatric Transplantation · doi:10.1111/j.1399-3046.2005.00352.x · Cited by 58
Self-Reported Non-Adherence and Beliefs About Medication in a Swedish Kidney Transplant Population
Lennerling, A., & Forsberg, A. (2012) · The Open Nursing Journal · doi:10.2174/1874434601206010041 · Cited by 58
“For transplant recipients, even minor variations from the prescribed immunosuppressive therapy have been shown to be associated with an increased risk for poor outcome such as late acute rejections, poor function and graft loss [8-12].”
BackgroundLamba, S., Nagurka, R., Desai, K. K., Chun, S. J., Holland, B. K., & Koneru, B. (2011) · Clinical Transplantation · doi:10.1111/j.1399-0012.2011.01489.x · Cited by 57
Symptom experience, nonadherence and quality of life in adult liver transplant recipients.
Drent, G., Geest, S. D., Dobbels, F., KLEIBEUKER, J. H., & Haagsma, E. B. (2009) · PubMed · Cited by 50
Ciancio, G., Sageshima, J., Chen, L., Gaynor, J. J., Hanson, L., Tueros, L., Velarde, E. M., Gomez, C. M. B., Kupin, W. L., Guerra, G., et al. (2012) · American Journal of Transplantation · doi:10.1111/j.1600-6143.2012.04235.x · Cited by 50
“Our results indicate that reduction or withholding of MMF contributed to the higher rate of acute rejection seen during the first 12 months in the MMF group, as inadequate MMF dosing has been associated with allograft loss due to acute rejection after kidney transplantation (18).”
ResultPost‐transplant adjustment – The later years
Fredericks, E. M., Zelikovsky, N., Aujoulat, I., Hames, A., & Wray, J. (2014) · Pediatric Transplantation · doi:10.1111/petr.12366 · Cited by 48
Chisholm, M. A., Mulloy, L. L., & DiPiro, J. T. (2004) · Clinical Transplantation · doi:10.1111/j.1399-0012.2004.00301.x · Cited by 44
Lung transplantation in Australia, 1986–2018: more than 30 years in the making
Paraskeva, M. A., Levin, K., Westall, G. P., & Snell, G. I. (2018) · The Medical Journal of Australia · doi:10.5694/mja17.00909 · Cited by 43
Cukor, D., Halen, N. V., Pencille, M., Tedla, F. M., & Salifu, M. O. (2016) · The Nephron journals/Nephron journals · doi:10.1159/000448627 · Cited by 41
Psychosocial predictors of medication adherence in pediatric heart and lung organ transplantation
Killian, M. (2017) · Pediatric Transplantation · doi:10.1111/petr.12899 · Cited by 41
Posttransplant Medical Adherence: What Have We Learned and Can We Do Better?
Dew, M. A., Posluszny, D. M., DiMartini, A. F., Myaskovsky, L., Steel, J. L., & Dabbs, A. D. (2018) · Current Transplantation Reports · doi:10.1007/s40472-018-0195-8 · Cited by 45
Factors Associated with Nonadherence to Medication in Kidney Transplant Recipients
Goldfarb‐Rumyantzev, A. S., Wright, S., Ragasa, R., Ostler, D., Orden, J. V., Smith, L. D., Ефимова, Е. А., Emerson, L. L., Sandhu, G. S., & Shihab, F. S. (2010) · Nephron Clinical Practice · doi:10.1159/000319645 · Cited by 41
“Having a living donor was predictive of worse adherence in our study. This outcome is consistent with most prior studies that found a similar association [”
ResultMEDICINE NON‐ADHERENCE IN KIDNEY TRANSPLANTATION
Williams, A. F., Manias, E., Gaskin, C. J., & Crawford, K. (2014) · Journal of Renal Care · doi:10.1111/jorc.12063 · Cited by 40
Russell, C. L., Ashbaugh, C., Peace, L. J., Çetingök, M., Hamburger, K. Q., Owens, S., Coffey, D., Webb, A. W., Hathaway, D., Winsett, R. P., et al. (2013) · Clinical Transplantation · doi:10.1111/ctr.12203 · Cited by 40
“Even minor deviations in adherence may lead to poor outcomes, although the dose–response of nonadherence and poor outcomes remains unclear (17, 19).”
BackgroundOperational tolerance in kidney transplantation and associated biomarkers
Massart, A., Ghisdal, L., Abramowicz, M. J., & Abramowicz, D. (2017) · Clinical & Experimental Immunology · doi:10.1111/cei.12981 · Cited by 39
“Finally, patient noncompliance (38) has been shown to significantly increase rates of late acute kidney rejection (38) and graft loss (39, 40).”
BackgroundMedication adherence in pediatric transplantation and assessment methods: a systematic review
Hoegy, D., Bleyzac, N., Robinson, P., Bertrand, Y., Dussart, C., & Janoly-Duménil, A. (2019) · Patient Preference and Adherence · doi:10.2147/ppa.s200209 · Cited by 38
“Assessment methodologies Period over which adherence was assessed The majority of studies (n=24) reported the period over which adherence was assessed; this ranged from 7 days(17,42) to 36 months.(15,18)The period was related to the method used: medication event monitoring systems (MEMS) generally examined adherence o…”
MethodSamojlik, M. M., & Stabler, C. L. (2021) · Acta Biomaterialia · doi:10.1016/j.actbio.2021.05.039 · Cited by 38
Adherence to immunosuppression in adult lung transplant recipients: Prevalence and risk factors
Bosma, O. H., Vermeulen, K. M., Verschuuren, E. A., Erasmus, M. E., & van der Bij, W. (2011) · The Journal of Heart and Lung Transplantation · doi:10.1016/j.healun.2011.05.007 · Cited by 40
Medication Adherence After Renal Transplantation—a Review of the Literature
Rebafka, A. (2016) · Journal of Renal Care · doi:10.1111/jorc.12181 · Cited by 37
Prevalence and determinants of physical activity and fluid intake in kidney transplant recipients
Gordon, E. J., PROHASKA, T. R., Gallant, M. P., Sehgal, A. R., Strogatz, D. S., Conti, D., & Siminoff, L. A. (2009) · Clinical Transplantation · doi:10.1111/j.1399-0012.2009.01154.x · Cited by 37
“It is well documented that patient behavior, such as medication adherence, is critical to successful management after kidney transplantation (9, 10).”
BackgroundPai, A. L. H., Rausch, J. R., Tackett, A. P., Marsolo, K. A., Drotar, D., & Goebel, J. (2012) · Pediatric Transplantation · doi:10.1111/j.1399-3046.2012.01657.x · Cited by 36
Bleser, L. D., Geest, S. D., Vandenbroeck, S., Vanhaecke, J., & Dobbels, F. (2010) · Sensors · doi:10.3390/s100301652 · Cited by 36
“In transplantation, for instance, taking less than 98% of the immunosuppressive doses results in significantly more graft losses [9].”
BackgroundTschida, S. J., Aslam, S., Khan, T. T., Sahli, B., Shrank, W. H., & Lal, L. S. (2013) · Journal of Managed Care Pharmacy · doi:10.18553/jmcp.2013.19.1.26 · Cited by 35
Ko, H., Kim, H. K., Chung, C. T. Y., Han, A., Min, S., Ha, J., & Min, S. (2021) · Scientific Reports · doi:10.1038/s41598-021-84868-5 · Cited by 35
Adherence is associated with a favorable outcome after lung transplantation
Bertram, A., Fuge, J., Suhling, H., Tudorache, I., Haverich, A., Welte, T., & Gottlieb, J. (2019) · PLoS ONE · doi:10.1371/journal.pone.0226167 · Cited by 34
“Other groups used the discrepancy between immunosuppressant dosages and prescription refills or data from health insurances for the assessment of adherence[35,36].”
MethodBurkhalter, H., Wirz‐Justice, A., Cajochen, C., Weaver, T. E., Steiger, J. U., Fehr, T. H., Venzin, R. M., & Geest, S. D. (2013) · Clinical Transplantation · doi:10.1111/ctr.12279 · Cited by 35
Heldenbrand, S. D., Li, C., Cross, R. P., DePiero, K. A., Dick, T. B., Ferguson, K., Kim, M., Newkirk, E. N., Park, J. M., Kerr, J., et al. (2016) · Transplant Infectious Disease · doi:10.1111/tid.12609 · Cited by 33
Corr, M., Walker, A., Maxwell, A. P., & McKay, G. J. (2024) · Transplantation Reviews · doi:10.1016/j.trre.2024.100900 · Cited by 32
Influence of Pill Burden and Drug Cost on Renal Function After Transplantation
Hardinger, K. L., Hutcherson, T. C., Preston, D., & Murillo, D. (2012) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1002/j.1875-9114.2012.01032.x · Cited by 32
Brahm, M. M. T., Manfro, R. C., de Mello, D., Cioato, S. G., & Gonçalves, L. F. S. (2012) · Transplantation Proceedings · doi:10.1016/j.transproceed.2012.08.001 · Cited by 30
Low, J. K., Crawford, K., Manias, E., & Williams, A. F. (2016) · Journal of Clinical Nursing · doi:10.1111/jocn.13435 · Cited by 28
Tielen, M., van Exel, J. N. A., van Buren, M. C., Maasdam, L., & Weimar, W. W. (2010) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfq642 · Cited by 27
“Non-adherence has been shown to be related to rejection and even graft failure [7–10].”
BackgroundBoucquemont, J., Pai, A. L. H., Dharnidharka, V. R., Hébert, D., Zelikovsky, N., Amaral, S. G., Furth, S. L., & Foster, B. J. (2019) · American Journal of Transplantation · doi:10.1111/ajt.15590 · Cited by 27
A New Electronic Monitoring Device to Measure Medication Adherence: Usability of the Helping Hand™
De Bleser, L., Vincke, B., Dobbels, F., Happ, M. B., Maes, B., Vanhaecke, J., & De Geest, S. (2010) · Sensors · doi:10.3390/s100301535 · Cited by 26
“These stringent cut-off values are based on previous work showing that minor deviations from dosing schedule are associated with late acute rejections [7,8].”
BackgroundTerebelo, S., & MARKELL, M. S. (2010) · Transplantation Proceedings · doi:10.1016/j.transproceed.2010.08.027 · Cited by 26
Evaluation of a transplantation specialty pharmacy program
Hlubocky, J., Stuckey, L. J., Schuman, A., & Stevenson, J. G. (2012) · American Journal of Health-System Pharmacy · doi:10.2146/ajhp110350 · Cited by 26
Lehner, L. J., Reinke, P., Hörstrup, J. H., Rath, T., Suwelack, B. M., Krämer, B. K., Budde, K., & Banas, B. (2017) · Clinical Transplantation · doi:10.1111/ctr.13142 · Cited by 26
Saint‐Marcoux, F., Woillard, J., Monchaud, C., Friedl, J., Bocquentin, F., Essig, M., & Marquet, P. (2015) · Pharmacological Research · doi:10.1016/j.phrs.2015.08.020 · Cited by 25
Tang, J., Kerklaan, J., Wong, G., Howell, M., Scholes-Robertson, N. J., Guha, C., Kelly, A., & Tong, A. (2021) · American Journal of Transplantation · doi:10.1111/ajt.16613 · Cited by 25
Gruttadauria, S., Grosso, G., Mistretta, A., Pagano, D., Scianna, G., Vizzini, G. B., Cintorino, D., Spada, M., Basile, F., & Gridelli, B. G. (2011) · Digestive and Liver Disease · doi:10.1016/j.dld.2011.06.017 · Cited by 25
Inosine Monophosphate Dehydrogenase Polymorphisms and Renal Allograft Outcome
Shah, S., Harwood, S., Döhler, B., Opelz, G., & Yaqoob, M. (2012) · Transplantation · doi:10.1097/tp.0b013e31825b7654 · Cited by 25
“C1842928 IVS 7 (10) 819+10 A9G rs11706052 Intron 7 IMPDH II CCACCTGTGT[A/ G]GCAGCTCACC 19”
Brar, A., Babakhani, A., Salifu, M. O., & Jindal, R. M. (2014) · Transplantation Proceedings · doi:10.1016/j.transproceed.2013.12.051 · Cited by 25
Psychosocial diagnosis and treatment before and after organ transplantation
de Zwaan, M., Erim, Y., Kröncke, S., Vitinius, F., Buchholz, A., & Nöhre, M. (2023) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.m2023.0087 · Cited by 24
Teng, S., Shuping, Z., Zhang, W., Lin, X., Shang, Y., Peng, X., & Liu, H. (2015) · Journal of Nursing Scholarship · doi:10.1111/jnu.12157 · Cited by 24
“Medication adherence is an important issue for organ transplant recipients, and nonadherence to immunosuppressive medication is one of the causes of acute rejection and graft loss (Denhaerynck et al., 2005; Gaynor et al., 2014; Takemoto, 2007).”
Backgroundde Brito, D. C. S., Marsicano, E. O., Grincenkov, F. R. D. S., Colugnati, F. A. B., Lucchetti, G., & Sanders‐Pinheiro, H. (2015) · Sao Paulo Medical Journal · doi:10.1590/1516-3180.2015.01071008 · Cited by 24
“0% (19) 1 Palliative coping 52% (13) 24.”
Russell, C. L., Moore, S. M., Hathaway, D., Cheng, A.-L., Chen, G., & Goggin, K. (2016) · BMC Nephrology · doi:10.1186/s12882-016-0285-8 · Cited by 26
What is the intrapatient variability of mycophenolic acid trough levels?
Todorova, E. K., Huang, S. S., Kobrzyński, M., & Filler, G. (2015) · Pediatric Transplantation · doi:10.1111/petr.12559 · Cited by 23
“An added challenge is the decreased immunosuppression compliance in pediatric and particularly adolescent patients as compared to adults (34).”
BackgroundCOOPER, M. M., Salvadori, M., Budde, K., Oppenheimer, F., Sollinger, H. W., & Zeier, M. (2012) · Transplantation Reviews · doi:10.1016/j.trre.2012.02.001 · Cited by 23
“Rates of dose reduction and/or discontinuations of MMF are consistently high [18,21,22] and have been demonstrated to be associated with a significantly increased risk of acute rejection and graft loss [18-25].”
BackgroundMedication compliance and lifestyle adherence in renal transplant recipients in Kuwait
Kenawy, A. S., Gheith, O. A. A., Al-Otaibi, T., Othman, N. F., Abo-Atya, H., Al-Otaibi, M., & Nagy, M. S. (2019) · Patient Preference and Adherence · doi:10.2147/ppa.s209212 · Cited by 22
“4,5,17 Our fi nding was also far lower than the prevalence of good compliance noticed by Gheith et al, with 97% compliance with immunosuppressants.”
Israni, A. K., Weng, F. L., Cen, Y., Joffe, M., Kamoun, M., & Feldman, H. I. (2010) · Clinical Transplantation · doi:10.1111/j.1399-0012.2010.01340.x · Cited by 22
Wilks, S. E., Spivey, C. A., & Chisholm‐Burns, M. A. (2010) · Journal of Evaluation in Clinical Practice · doi:10.1111/j.1365-2753.2008.01115.x · Cited by 22
Vaňková, B., Ribaut, J., Dobbels, F., Gerull, S., Malá‐Ládová, K., Zullig, L. L., & Geest, S. D. (2021) · Transplantation Reviews · doi:10.1016/j.trre.2021.100671 · Cited by 23
Su, V., Greanya, E. D., & Ensom, M. H. H. (2011) · Annals of Pharmacotherapy · doi:10.1345/aph.1p456 · Cited by 22
Symptom Experienced Three Years after Liver Transplantation under Immunosuppression in Adults
Wang, C., Wang, G., Yi, H., Tan, J., Xu, C., Fang, X., Yang, Y., Li, H., Chen, Q., & Chen, G. (2013) · PLoS ONE · doi:10.1371/journal.pone.0080584 · Cited by 21
“A link between symptom experience and nonadherence has been found in patients who have undergone other types of organ transplantations, such as heart, renal, and lung transplantations [13,17,24-26].”
BackgroundRetractedTransplant recipients are vulnerable to coverage denial under Medicare Part D
Potter, L., Maldonado, A. Q., Lentine, K. L., Schnitzler, M. A., Zhang, Z., Hess, G. P., Garrity, E. R., Kasiske, B. L., & Axelrod, D. A. (2018) · American Journal of Transplantation · doi:10.1111/ajt.14703 · Cited by 21
Self-citationMedication adherence in successful kidney transplant recipients.
Ruppar, T. M., & Russell, C. L. (2009) · PubMed · doi:10.1177/152692480901900211 · Cited by 20
Increasing adherence to immunosuppression: a clinical priority
Geest, S. D., & Dobbels, F. (2010) · Nature Reviews Nephrology · doi:10.1038/nrneph.2010.11 · Cited by 20
“Increasing evidence suggests that nonadherence increases the risk of poor outcomes, particularly after kidney and heart transplantation”
Andrés, A., Delgado-Arranz, M., Morales, E., Dipalma, T., Polanco, N., Gutiérrez-Solís, E., Morales, J. M., Praga, M., Gutiérrez, E., & González, E. (2010) · Transplantation Proceedings · doi:10.1016/j.transproceed.2010.07.044 · Cited by 18
Medication adherence in successful kidney transplant recipients
Ruppar, T. M., & Russell, C. L. (2009) · Progress in Transplantation · doi:10.7182/prtr.19.2.2652p03x0vvx7665 · Cited by 18
Reinke, P., Budde, K., Hugo, C., Petersen, P., Schnuelle, P., Fricke, L., Scholz, D., Sperschneider, H., Bahner, U., Kramer, S., et al. (2011) · Transplantation Proceedings · doi:10.1016/j.transproceed.2011.01.184 · Cited by 17
Adherence in Adolescent and Young Adult Kidney Transplant Recipients
Bethany, J. F., & Ahna, L. H. P. (2014) · The Open Urology & Nephrology Journal · doi:10.2174/1874303x014070100133 · Cited by 19
“6 times higher in those 19-24 years than among those 25-44 years old [15].”
InfluentialSterneck, M. R., Settmacher, U., Ganten, T. M., Sarrazin, C., Speidel, N., Broering, D., Heyne, N., Paulus, E., Mertens, M., & Fischer, L. (2014) · Transplantation Proceedings · doi:10.1016/j.transproceed.2013.09.026 · Cited by 17
Metadata
- Authors
- Takemoto, S. K., Pinsky, B. W., Schnitzler, M. A., Lentine, K. L., Willoughby, L. M., Burroughs, T. E., & Bunnapradist, S.
- Affiliations
- Saint Louis University (US)
- University of California, Los Angeles (US)
- Corresponding author
- Takemoto, S.K.
- Venue
- American Journal of Transplantation
- Publisher
- Elsevier BV
- Published
- 2007-12
- Volume
- 7
- Issue
- 12
- Pages
- 2704-2711
- ISSN
- 1600-6135 (ISSN-L)
- OpenAlex
- W2020224358
- Cited by
- 202
- References
- 40
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 7 · 2022: 7 · 2021: 12 · 2020: 7 · 2019: 14 · 2018: 8 · 2017: 6 · 2016: 7 · 2015: 9 · 2014: 20 · 2013: 15 · 2012: 23
- FWCI
- 9.09
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- American Journal of Transplantation (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (K08DK073036)
- Topics
- Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Keywords
- kidney transplantation, medication possession ratio, mycophenolate mofetil, dose reduction, drug discontinuation, graft loss, graft rejection, delayed graft function, hypertension, gastrointestinal diseases
- MeSH terms
- Adolescent, Adult, Child, Child, Preschool, Dose-Response Relationship, Drug, Gastrointestinal Diseases, Graft Rejection, Medicare, Humans, Immunosuppressive Agents, Infant, Infant, Newborn, Insurance Claim Review, Middle Aged, Mycophenolic Acid, Patient Compliance, Retrospective Studies, Risk Factors, United States, Logistic Models, Proportional Hazards Models, Kidney Transplantation, Treatment Outcome
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