MEDICATION COMPLIANCE FOLLOWING RENAL TRANSPLANT

Abstract

682 This study investigated variables that impacted compliance with medication regimen post renal transplant. Medication compliance was measured by two items obtained through patient self-report on a mailed survey: 1. Frequency of forgetting to take medications and 2. Frequency of not taking medications exactly as prescribed. Objective independent variables were: age; education; gender; marital status; Medicaid status (indicator of economic status); number of medications; race; type of transplant and years since transplant. Subjective independent variables were: SF36; Illness Intrusiveness Rating Scale; Multidimensional Health Locus of Control Scale (MHLC); Social Support Appraisals Scale. In addition, two transplant specific items focused on whether patients experienced difficulty paying for immunosuppressants; and whether patients felt bothered by any part of the transplant experience (bothered). The sample consisted of 357 patients who met inclusion criteria for study participation. Data were analyzed using descriptive and multivariate analyses. Forgetting to take medication was predicted by a model with an R2=.088. Variables found to be significant in this model were: bothered; age; pain (SF36 subscale); and chance (MHLC subscale). Forgetting to take medication was associated with younger age; perception of less pain; believing that health outcomes were a matter of chance and feeling bothered by part of the transplant experience. Not taking medications exactly as prescribed was predicted by a model with an R2=.115. Variables found to be significant in the model were: powerful others (MHLC); social functioning(SF36 subscale); bothered; internal (MHLC). Taking medications exactly as prescribed was associated with a greater belief that powerful others controlled health outcomes; perception of a higher level of social functioning; not feeling bothered by the transplant experience and having less belief in internal control for health outcomes. Variables previously found to be related to medication compliance, such as race, gender, number of medications and time since transplant, were notably absent. Variables one might suspect to be important, such as socioeconomic status and difficulty paying for medications were also not significant in the final models. Variables that reflected patients' feelings and perceptions were critical. Feelings regarding faith in their physicians and positive feelings about their transplant experience increased compliance. Current trends in the health care environment make these findings particularly relevant for the evaluation of services provided by transplant programs.