Satisfaction and adherence with immunosuppressant treatment in renal transplant patients living with a working graft

Abstract

The aim of this study was to analyze patient satisfaction and adherence in a sample of renal transplant patients living with a working allograft. An epidemiological cross-sectional multicenter study was carried out with renal recipients who had received a transplant 6-24 months before and were undergoing immunosuppressant therapy (IT). Sociodemographic and clinical variables registered were dosage, allograft functioning, number of medications, health-related quality of life (HRQoL by SF-6D), patients' satisfaction (SAT-Q) and adherence to medication (abnormal levels of immunosuppressant in blood tests [ALIBT] and clinical impression). Relationships between those parameters were contrasted (chi-square test, Spearman correlation coefficient and Mann-Whitney U-test). Multivariate regression models (linear and logistic) were computed to analyze the factors related to patients' satisfaction and adherence to medication, respectively. Data from 206 patients were collected (61.2% males with a mean age of 53.35 years). Nonadherence rates (29.1% and 31.1%) were found according to clinical impression and ALIBT, respectively (chi-square = 31.810, p<0.001). Overall, global patients' satisfaction (74.000 ± 1.251) and HRQoL (0.765 ± 0.011) levels were high. Low-moderate significant associations between satisfaction and adherence to IT and HRQoL were found (p<0.01). Finally, age, vitality, allograft functioning and dosage were correlated with patient satisfaction (R2=0.174; F(1,185)=4.134; p<0.043). Number of medications (odds ratio [OR] = 0.890; 95% confidence interval [95% CI], 0.812-0.975; p=0.012), convenience domain (OR=1.037; 95% CI, 1.005-1.070; p=0.021) and clinical criteria (OR=6.135; 95% CI, 2.945-12.782; p<0.001) were associated with adherence. In renal transplant patients, satisfaction with IT is related to the levels of HRQoL and compliance.