Medication compliance following renal transplantation

Background. There appears to be general consensus that a relationship exists between noncompliance and clinical outcomes in health care, including renal transplantation. This study investigated variables associated with medication noncompliance after renal transplantation. Methods. A mail survey containing objective and subjective variables was sent to individuals who met eligibility criteria. Medication compliance was measured by two items: 1) Frequency of forgetting to take medications and 2) Frequency of not taking medications exactly as prescribed. Descriptive and multivariate analyses were utilized to examine the data. Results. Individuals who were older and those who perceived less pain were less likely to forget medications. The belief that health outcomes were controlled by chance and feeling bothered by part of the transplant experience were associated with greater likelihood of forgetting medications. Individuals who perceived a higher level of social functioning and those who believed that health outcomes were controlled by powerful others were more likely to take medications exactly as prescribed. An internal locus of control for health outcomes and feeling bothered by part of the transplant experience were associated with less likelihood of taking medication exactly as prescribed. Conclusions. The finding of this study suggest that compliance with medications after renal transplant is associated with subjective, not objective variables. Positive feelings regarding their physicians and the transplant experience increased compliance. Combining consistent measurement of compliance, examination of its relationship to clinical outcomes, and appreciation for the patient perspective should result in increased levels of compliance and better clinical outcomes.