Title: Prevalence, consequences, and determinants of nonadherence in adult renal transplant patients: a literature review
Authors: Denhaerynck, Kris ×
Dobbels, Fabienne
Cleemput, Irina
Desmyttere, Ariane
Schäfer-Keller, Petra
Schaub, Stefan
De Geest, Sabina #
Issue Date: Oct-2005
Publisher: Springer International
Series Title: Transplant International vol:18 issue:10 pages:1121-1133
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.
ISSN: 0934-0874
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Academic Centre for Nursing and Midwifery
Interfaculty Centre for Biomedial Ethics and Law
× corresponding author
# (joint) last author

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