Non-compliance after solid organ transplantation: the experience of Padua University Hospital

The effectiveness of any treatment depends not only on the right choice of therapy, but also to a large extent on the patient's active cooperation. Adherence to medical prescriptions and immunosuppressive therapy is crucial in transplanted patients, to prevent medical complications that negatively influence graft function and patient survival. The aim of this study was to assess adherence to medical regimen and adequate lifestyle among solid organ transplant recipients. Patients who underwent solid organ transplantation at Padua University Hospital (2008-09) were included in the study. All participants filled in a questionnaire to assess non-compliance. 218 organ transplanted patients were enrolled: 152 men and 66 women, mean age 54 years and mean time from transplantation 84.5 months. Non-adherence to immunosuppressive therapy was reported by 38% of patients and non-adherence to adequate lifestyle was referred by 38.5% of patients. Considering non-adherence to immunosuppressive therapy and to general prescriptions the percentage of kidney transplanted patients who referred non-adherence was significantly lower compared to other organ transplanted patients. Considering non-adherence to an adequate lifestyle, the percentage of liver transplanted patients who referred non-adherence was significantly higher compared to other organ transplanted patients. Poor adherence to medical prescriptions and to adequate lifestyle was very common among organ transplanted patients

Nonadherent Behaviors After Solid Organ Transplantation

Background and aim. The effectiveness of any treatment depends not only on the choice of therapy, but also, to a large extent, on the patient's active cooperation. Adherence to medical prescriptions and particularly to immunosuppressive therapy is crucial to prevent medical complications that negatively influence graft function and patient survival after organ transplantation. The aim of this study was to assess, among patients who underwent solid organ transplantation, nonadherent behaviors (NAB) to immunosuppressive therapy, to correct lifestyle, and to general medical prescriptions. Materials and methods. We evaluated patients who underwent solid organ transplantation from March 2008 to June 2009. All participants completed an anonymous 15-item questionnaire to assess NAB. Results. We enrolled 218 organ transplant patients: 103 liver, 50 kidney, 52 heart, and 13 lung. There were 152 men and the overall age was 52.2 +/- 0.8 years (mean standard deviation [SD]) time from transplantation, 83.6 +/- 4.5 months (mean +/- SD). Overall 37.9%, 38.8%, and 12.8% of patients reported nonadherence to immunosuppressive therapy, to correct lifestyle, and to general medical prescriptions, respectively. Considering nonadherence to irnmunosuppressive therapy and to general prescriptions, the percentage of kidney transplant patients who referred NAB was significantly lower compared with other organ transplant patients (P = .008 and P = .04, respectively). Nonadherent patients to immunosuppressive therapy and to general medical prescriptions displayed a longer interval from transplantation compared with adherent patients (P = .02 and P = .03, respectively). Among patients nonadherent to the correct lifestyle, the rates of men and of patients with disability pension were significantly higher compared to adherent patients (P = .001 and P = .002, respectively). Conclusions: Poor adherence to medical prescriptions and to adequate lifestyle is common among organ transplant patients, especially those who have undergone liver transplantation. Psychoeducational interventions for transplanted patients and their families are needed to improve adherence