Evaluation of Experiences with Immunosuppressive Drugs in Transplantation: Validation of the MESI Scale in French

Abstract

Patients’ experiences of immunosuppressive treatment, including their perception of adverse effects, influences their quality of life and may be a trigger for poor adherence. The Medication Experience Scale for Immunosuppressants (MESI) questionnaire was designed in German to evaluate patients’ experiences of immunosuppressive drugs. The objective of this study was to validate the MESI in French. The MESI was transculturally adapted and validated in French-speaking transplant recipients according to international guidelines. Statistical analysis was performed using R version 3.2.3, and the psychometric properties of the MESI were determined using the psy R package. Validation was performed in 164 kidney, liver, lung, and heart transplant recipients (aged 55.4 ± 13.1 years, 62.8% males, years since transplantation 7.5 ± 7.9). The MESI displayed good psychometric characteristics (intra-class correlation coefficient 0.854, Cronbach’s α 0.79 (95% confidence interval 0.74–0.83, Kappa coefficient 0.30–0.76). There was an association between the MESI score, family status, and the transplanted organ (p < 0.05). Almost half of the patients believed that adverse events would always persist. The good psychometric properties of the French version of the MESI allow evaluation of French-speaking patients’ experiences and attitudes towards their immunosuppressive treatment and, therefore, identification of patients at risk of poor adherence. This simple tool could help healthcare providers screen patients for the risk of poor adherence before any adherence issues appear.