Marina Serper|Rachel E. Patzer|Peter P. Reese|Kamila Przytula|R. Koval|Daniela P. Ladner|Josh Levitsky|Michaël Abécassis|Michael S. Wolf
Medication misuse, nonadherence, and clinical outcomes among liver transplant recipients
Georgia Department of Public Health|Emory University|University of Pennsylvania|General Department of Preventive Medicine|Emory University|Northwestern University|Northwestern University|Northwestern University|Northwestern University|General Department of Preventive Medicine
medication nonadherence liver transplantation lt associated adverse clinical outcomes graft rejection graft loss studies examined nonadherence impact clinical outcomes lt study objectives 1 evaluate medication understanding treatment knowledge demonstrated regimen use scores medication adherence nonadherence entire regimens among lt recipients 2 examine associations exposures clinical outcomes conducted 2site study 105 recipients 2011 2012 2 transplant centers chicago il atlanta ga data collected via detailed inperson interviews medical record reviews study participants middleaged predominantly male 15 sample limited literacy average patients taking 11 medications standard deviation sd 4 39 undergone medication change within last month average scores entire medication regimen 86 sd 22 treatment knowledge 78 sd 22 demonstrated regimen use mean score selfreported nonadherence entire regimen 14 sd 20 whereas 32 patients nonadherent according tacrolimus levels multivariate analyses lower income less time since transplantation higher number medications limited literacy inversely associated treatment knowledge scores p 005 whereas limited literacy associated nonadherence according tacrolimus levels p 005 multivariate models higher scores treatment knowledge incidence rate ratio irr 085 95 confidence interval ci 074097 demonstrated regimen use irr 087 95 confidence interval 077098 independently associated 15 13 reductions number posttransplant rehospitalizations respectively inadequate treatment knowledge improper regimen use may significant determinants unintentional nonadherence among lt recipients associated adverse clinical outcomes