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.
Original language | English (US) |
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Pages (from-to) | 1294-1305 |
Number of pages | 12 |
Journal | Clinical Transplantation |
Volume | 30 |
Issue number | 10 |
DOIs | |
State | Published - Oct 1 2016 |
Funding
We would like to acknowledge Ruth M. Parker, MD, Tess Gallegos, Michelle Miller, Brendan Lovasik, MD, Titilayo Ilori, MD, Audra Williams, MD, Paul Jurgens, Lisa T. Belter, Jennifer P. King, MPH, and John Friedewald, MD, for their assistance with this project. This project was supported by Award Number T32DK077662 from the National Institute of Diabetes and Digestive and Kidney Diseases. R.E. Patzer and M.S. Wolf are supported in part by R21NR014544.
Keywords
- cognition
- hospitalization
- kidney transplantation
- literacy
- medication adherence
ASJC Scopus subject areas
- Transplantation