Abstract
We sought to evaluate the prevalence of medication understanding and non-adherence of entire drug regimens among kidney transplantation (KT) recipients and to examine associations of these exposures with clinical outcomes. Structured, in-person interviews were conducted with 99 adult KT recipients between 2011 and 2012 at two transplant centers in Chicago, IL; and Atlanta, GA. Nearly, one-quarter (24%) of participants had limited literacy as measured by the Rapid Estimate of Adult Literacy in Medicine test; patients took a mean of 10 (SD=4) medications and 32% had a medication change within the last month. On average, patients knew what 91% of their medications were for (self-report) and demonstrated proper dosing (via observed demonstration) for 83% of medications. Overall, 35% were non-adherent based on either self-report or tacrolimus level. In multivariable analyses, fewer months since transplant and limited literacy were associated with non-adherence (all P<.05). Patients with minority race, a higher number of medications, and mild cognitive impairment had significantly lower treatment knowledge scores. Non-white race and lower income were associated with higher rates of hospitalization within a year following the interview. The identification of factors that predispose KT recipients to medication misunderstanding, non-adherence, and hospitalization could help target appropriate self-care interventions.
| Language | English (US) |
|---|---|
| Pages | 1294-1305 |
| Number of pages | 12 |
| Journal | Clinical Transplantation |
| Volume | 30 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 1 2016 |
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Keywords
- cognition
- hospitalization
- kidney transplantation
- literacy
- medication adherence
ASJC Scopus subject areas
- Transplantation
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Medication understanding, non-adherence, and clinical outcomes among adult kidney transplant recipients. / Patzer, Rachel E.; Serper, Marina; Reese, Peter P.; Przytula, Kamila; Koval, Rachel; Ladner, Daniela P.; Levitsky, Josh M.; Abecassis, Michael M.; Wolf, Michael S.
In: Clinical Transplantation, Vol. 30, No. 10, 01.10.2016, p. 1294-1305.Research output: Contribution to journal › Article
TY - JOUR
T1 - Medication understanding, non-adherence, and clinical outcomes among adult kidney transplant recipients
AU - Patzer,Rachel E.
AU - Serper,Marina
AU - Reese,Peter P.
AU - Przytula,Kamila
AU - Koval,Rachel
AU - Ladner,Daniela P.
AU - Levitsky,Josh M.
AU - Abecassis,Michael M.
AU - Wolf,Michael S.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - We sought to evaluate the prevalence of medication understanding and non-adherence of entire drug regimens among kidney transplantation (KT) recipients and to examine associations of these exposures with clinical outcomes. Structured, in-person interviews were conducted with 99 adult KT recipients between 2011 and 2012 at two transplant centers in Chicago, IL; and Atlanta, GA. Nearly, one-quarter (24%) of participants had limited literacy as measured by the Rapid Estimate of Adult Literacy in Medicine test; patients took a mean of 10 (SD=4) medications and 32% had a medication change within the last month. On average, patients knew what 91% of their medications were for (self-report) and demonstrated proper dosing (via observed demonstration) for 83% of medications. Overall, 35% were non-adherent based on either self-report or tacrolimus level. In multivariable analyses, fewer months since transplant and limited literacy were associated with non-adherence (all P<.05). Patients with minority race, a higher number of medications, and mild cognitive impairment had significantly lower treatment knowledge scores. Non-white race and lower income were associated with higher rates of hospitalization within a year following the interview. The identification of factors that predispose KT recipients to medication misunderstanding, non-adherence, and hospitalization could help target appropriate self-care interventions.
AB - We sought to evaluate the prevalence of medication understanding and non-adherence of entire drug regimens among kidney transplantation (KT) recipients and to examine associations of these exposures with clinical outcomes. Structured, in-person interviews were conducted with 99 adult KT recipients between 2011 and 2012 at two transplant centers in Chicago, IL; and Atlanta, GA. Nearly, one-quarter (24%) of participants had limited literacy as measured by the Rapid Estimate of Adult Literacy in Medicine test; patients took a mean of 10 (SD=4) medications and 32% had a medication change within the last month. On average, patients knew what 91% of their medications were for (self-report) and demonstrated proper dosing (via observed demonstration) for 83% of medications. Overall, 35% were non-adherent based on either self-report or tacrolimus level. In multivariable analyses, fewer months since transplant and limited literacy were associated with non-adherence (all P<.05). Patients with minority race, a higher number of medications, and mild cognitive impairment had significantly lower treatment knowledge scores. Non-white race and lower income were associated with higher rates of hospitalization within a year following the interview. The identification of factors that predispose KT recipients to medication misunderstanding, non-adherence, and hospitalization could help target appropriate self-care interventions.
KW - cognition
KW - hospitalization
KW - kidney transplantation
KW - literacy
KW - medication adherence
UR - http://www.scopus.com/inward/record.url?scp=84991106848&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84991106848&partnerID=8YFLogxK
U2 - 10.1111/ctr.12821
DO - 10.1111/ctr.12821
M3 - Article
VL - 30
SP - 1294
EP - 1305
JO - Clinical Transplantation
T2 - Clinical Transplantation
JF - Clinical Transplantation
SN - 0902-0063
IS - 10
ER -