Abstract
In this review, we provide an overview of the most current evidence on the prevalence, risk factors, and consequences of medication non-adherence (NA) in liver transplant recipients. Despite the improvement in long-term liver transplantation outcomes, medication NA is the leading cause of graft failure, graft rejection, and poor clinical outcomes. We examine methods of measuring NA as well as interventions that have been carried out to improve medication adherence and posttransplantation outcomes. Common risk factors for NA include low social support, medication-related factors (eg. side effects), regimen complexity, younger age, financial barriers, and low literacy. Additionally, we discuss special at-risk populations with pretransplantation substance abuse or psychiatric comorbidities as well as adolescents making a transition into adulthood and independent self-care. Multifaceted interventions that are personalized and specific to identified adherence barriers for high-risk groups seem to be the most promising approach to improve medication NA and posttransplantation outcomes. This review contains 4 figures, 5 tables, and 53 references Key Words: electronic monitoring, immunosuppression, liver transplantation, medication, nonadherence, noncompliance, tacrolimus standard deviation, transplantation outcomes
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