Main Article Content
Abstract
Introduction: Adherence to immunotherapy decreases rejection and graft loss, so it is necessary to identify clinical variables related to adherence in adult renal transplant recipients to optimise renal graft survival.
Objetive: To assess the prevalence of adherence to immunotherapy and its relationship with clinical variables in young adult kidney transplant recipients in a tertiary hospital.
Material and Method: Descriptive cross-sectional observational study. A non-probabilistic convenience sample was taken from 45 adult kidney transplant recipients. Sociodemographic and clinical variables, anxiety, and depression were studied. The Basel Assessment of Adherence to Immunosuppressive Medications Scale was used to assess adherence.
Results: The mean age of the participants was 33.7±9.4 years. The majority were men (66.7%). The prevalence of non-adherence was 75.5%; an association was observed between adherence and the reason for hospital admission and anxiety. Non-adherent adults showed problems such as forgetting to take the immunosuppressant and delay of at least 2 hours in taking the medication.
Conclusions: The prevalence of non-adherence to immunotherapy was higher than reported in previous studies, so continued intervention is needed to improve adherence to immunosuppressive therapy recommendations.
Keywords
Article Details
Copyright (c) 2024 Rosa María Rodríguez Medina, Yosileb Sinai Aranda Hernández, María Beatriz Cruz Sánchez, Carlos Francisco Meza García

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References
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- Massey EK, Meys K, Kerner R, Weimar W, Roodnat J, Cransberg K. Young adult kidney transplant recipients: Nonadherent and happy. Transplantation. 2015;99(8):89-96. DOI: https://doi.org/10.1097/TP.0000000000000639
- Lalić J, Velicković-Radovanović R, Mitić B, Paunović G, Cvetković T. Immunosuppressive medication adherence in kidney transplant patients. Med Princ Pract. 2014;23(4):351-6. DOI: https://doi.org/10.1159/000362792
- Matsuda-Abedini M, Marks SD, Foster BJ. Transition of young adult kidney transplant recipients. Pediatr Nephrol. 2023;38(2):383-90. DOI: https://doi.org/10.1007/s00467-022-05582-6
- Van Zanten R, de Weerd A, Betjes M, Boer-Verschragen M, Massey EK. Is simplification of immunosuppressive medication a way to promote medication adherence of kidney transplant recipients? Findings from a randomized controlled trial. Transpl Int. 2021;34(9):1703-11. DOI: https://doi.org/10.1111/tri.13993
- Uyar B. The analysis of immunosuppressant therapy adherence, depression, anxiety, and stress in kidney transplant recipients in the post-transplantation period. Transpl Immunol. 202;75:101686. DOI: https://doi.org/10.1016/j.trim.2022.101686
- Rebafka A. Medication adherence after renal transplantation—a review of the literature. J Ren Care. 2016;42(4):239-56. DOI: https://doi.org/10.1111/jorc.12181
- Varnell CD, Rich KL, Modi AC, Hooper DK, Eckman MH. A cost-effectiveness analysis of adherence promotion strategies to improve rejection rates in adolescent kidney transplant recipients. Am J Kidney Dis. 2022;80(3):330-40. DOI: https://doi.org/10.1053/j.ajkd.2021.12.013
- Kim S, Ju MK, Son S, Jun S, Lee SY, Han CS. Development of video-based educational materials for kidney-transplant patients. PLoS One. 2020;15(8):0236750. DOI: https://doi.org/10.1371/journal.pone.0236750
- Pedreira-Robles G, Garcimartín P, Bach-Pascual A, Giró-Formatger D, Redondo-Pachón D, Morín-Fraile V. Creating the nursing care map in the evaluation of kidney transplant candidates: A scoping review and narrative synthesis. Nursing Open 2023;10:6668–89. DOI: https://doi.org/10.1002/nop2.1937
References
Ali A, Al-Taee HA, Jasim MS. Adherence to Immunosuppressive Medication in Iraqi Kidney Transplant Recipients During the First Year of Transplant. A Single-Center Experience. Exp Clin Transplant. 2022;20(3):107-12. DOI: https://doi.org/10.6002/ect.MESOT2021.P44
Nevins TE, Nickerson PW, Dew MA. Understanding Medication Nonadherence after Kidney Transplant. J Am Soc Nephrol. 2017;28(8):2290-301. DOI: https://doi.org/10.1681/ASN.2017020216
Weng LC, Yang YC, Huang HL, Chiang YJ, Tsai YH. Factors that determine self-reported immunosuppressant adherence in kidney transplant recipients: a correlational study. J Adv Nurs. 2017;73(1):228-39. DOI: https://doi.org/10.1111/jan.13106
Villeneuve C, Rousseau A, Rerolle JP, Couzi L, Kamar N, Essig M, et al. Adherence profiles in kidney transplant patients: Causes and consequences. Patient Educ Couns. 2020;103(1):189-98. DOI: https://doi.org/10.1016/j.pec.2019.08.002
Doalto-Muñoz Y, Valle RC, Manrique MLC. Factores asociados a la resiliencia y adherencia terapéutica en pacientes con injerto renal funcionante. Enferm Nefrol. 2018;21(2):123-9. DOI: https://doi.org/10.4321/S2254-28842018000200003
Argüeso-Gómez L, Rodrigo-Calabia E, Pelayo-Alonso R, de Cos-Cossío MÁ. Adherencia al tratamiento en pacientes con trasplante renal y su relación con los niveles plasmáticos de inmunosupresores. Enferm Nefrol. 2023;26(4):344-50. DOI: https://doi.org/10.37551/S2254-28842023033
Belaiche S, Décaudin B, Dharancy S, Noel C, Odou P, Hazzan M. Factors relevant to medication non-adherence in kidney transplant: a systematic review. Int J Clin Pharm. 2017;39(3):582-93. DOI: https://doi.org/10.1007/s11096-017-0436-4
Guillén Díaz-Barriga C, González-Celis Rangel AL. Propiedades psicométricas del Inventario de Ansiedad de Beck en adultos asmáticos mexicanos. Psicología y Salud. 2018;29(1):5-16. DOI: https://doi.org/10.25009/pys.v29i1.2563
Brito DCS de, Machado EL, Reis IA, Cherchiglia LP de F do CML. Depression and anxiety among patients undergoing dialysis and kidney transplantation: A cross-sectional study. Sao Paulo Med J. 2019;137(2):137-47. DOI: https://doi.org/10.1590/1516-3180.2018.0272280119
Sevinc M, Hasbal NB, Sakaci T, Basturk T, Ahbap E, Ortaboz M, et al. Frequency of depressive symptoms in Syrian refugees and Turkish maintenance hemodialysis patients during COVID-19 pandemic. PLoS One. 2021;16(1):0244347. DOI: https://doi.org/10.1371/journal.pone.0244347
Baloch MH AA. Prevalence of anxiety and depression in chronic kidney disease patients according to CKD stages. Isra Med J. 2017;9(5):280–3.
Low JK, Manias E, Crawford K, Walker R, Mulley WR, Toussaint ND, et al. Improving medication adherence in adult kidney transplantation (IMAKT): A pilot randomised controlled trial. Sci Rep. 2019;9:7734. DOI: https://doi.org/10.1038/s41598-019-44002-y
Krause AV, Bertram A, Nöhre M, Bauer-Hohmann M, Schiffer M, De Zwaan M. Use of an electronic medication monitoring device to estimate medication adherence in kidney transplant patients. Transl Behav Med. 2021;11(3):842–51. DOI: https://doi.org/10.1093/tbm/ibaa122
Rodríguez-Medina RM, et al. https://doi.org/10.37551/S2254-28842024017 DOI: https://doi.org/10.37551/S2254-28842024017
Secretaría de Gobernación de México. Reglamento de la Ley General de Salud en materia de investigación para la salud. Publicado en Diario Oficial de la Federación en 2014.
Martínez-Mier G, Ávila-Pardo SF, Irigoyen-Castillo A, Rodríguez-Fernández A, Jiménez-López LA, Varela-Pérez V. Análisis de la supervivencia a 10 años de trasplante renal en el Hospital de Alta Especialidad de Veracruz. Rev Mex Traspl. 2016;5(3):113–9.
Ayala-García MA, Díaz-Chávez E, Soel-Encalada JM, Orozco-Mosqueda A, Balandrán-Ortiz MH, Ceja-Guzmán SR, et al. Supervivencia de los pacientes receptores de trasplante renal. Gac Med Mex. 2020;156(1):34–9. DOI: https://doi.org/10.24875/GMM.19005434
Taj SM, Baghaffar H, Alnajjar DK, Almashabi NK, Ismail S. Prevalence of non-adherence to immunosuppressive medications in kidney transplant recipients: Barriers and predictors. Ann Transplant. 2021;26:928356. DOI: https://doi.org/10.12659/AOT.928356
Massey EK, Meys K, Kerner R, Weimar W, Roodnat J, Cransberg K. Young adult kidney transplant recipients: Nonadherent and happy. Transplantation. 2015;99(8):89-96. DOI: https://doi.org/10.1097/TP.0000000000000639
Lalić J, Velicković-Radovanović R, Mitić B, Paunović G, Cvetković T. Immunosuppressive medication adherence in kidney transplant patients. Med Princ Pract. 2014;23(4):351-6. DOI: https://doi.org/10.1159/000362792
Matsuda-Abedini M, Marks SD, Foster BJ. Transition of young adult kidney transplant recipients. Pediatr Nephrol. 2023;38(2):383-90. DOI: https://doi.org/10.1007/s00467-022-05582-6
Van Zanten R, de Weerd A, Betjes M, Boer-Verschragen M, Massey EK. Is simplification of immunosuppressive medication a way to promote medication adherence of kidney transplant recipients? Findings from a randomized controlled trial. Transpl Int. 2021;34(9):1703-11. DOI: https://doi.org/10.1111/tri.13993
Uyar B. The analysis of immunosuppressant therapy adherence, depression, anxiety, and stress in kidney transplant recipients in the post-transplantation period. Transpl Immunol. 202;75:101686. DOI: https://doi.org/10.1016/j.trim.2022.101686
Rebafka A. Medication adherence after renal transplantation—a review of the literature. J Ren Care. 2016;42(4):239-56. DOI: https://doi.org/10.1111/jorc.12181
Varnell CD, Rich KL, Modi AC, Hooper DK, Eckman MH. A cost-effectiveness analysis of adherence promotion strategies to improve rejection rates in adolescent kidney transplant recipients. Am J Kidney Dis. 2022;80(3):330-40. DOI: https://doi.org/10.1053/j.ajkd.2021.12.013
Kim S, Ju MK, Son S, Jun S, Lee SY, Han CS. Development of video-based educational materials for kidney-transplant patients. PLoS One. 2020;15(8):0236750. DOI: https://doi.org/10.1371/journal.pone.0236750
Pedreira-Robles G, Garcimartín P, Bach-Pascual A, Giró-Formatger D, Redondo-Pachón D, Morín-Fraile V. Creating the nursing care map in the evaluation of kidney transplant candidates: A scoping review and narrative synthesis. Nursing Open 2023;10:6668–89. DOI: https://doi.org/10.1002/nop2.1937