Abstract:
OBJECTIVE:Adherence to immunosuppressants (IS) is crucial to prevent allograft rejection. Even though there is evidence that non-adherence to IS among kidney transplant recipients is common, it is rarely routinely assessed in clinical practice. Especially, little is known about how physicians estimate patients' adherence to IS medication. METHODS:In a single center, cross-sectional study adult patients at least 1 year after kidney transplantation were asked to complete measures of adherence (BAASIS©, Transplant Effect Questionnaire) and of general psychopathology (anxiety, depression, perceived social support). Also the physicians were asked to estimate their patients' adherence. Medical data (time since transplantation, treatment for rejection, IS serum trough levels and target levels) were taken from the patients' charts. RESULTS:Physicians rated 22 of 238 (9.2%) patients as non-adherent. Physicians' estimations of non-adherence were lower compared to the results of the self-ratings and biopsy-proven rejections. No association was found between physicians' estimates and the variability of IS through levels. Significantly more women and patients who reported that their native language was not German were rated as non-adherent by the physicians. Also, physician-rated non-adherent patients reported significantly higher depression and anxiety scores as well as less social support compared to adherent patients. CONCLUSION:Our results suggest that physicians tend to underestimate patient non-adherence to IS medication. They appear to use observable cues such as sex, language skills, and elevated anxiety and depression scores in particular, to make inferences about an individual patient's adherence. Underestimation of medication non-adherence may impede physicians' ability to provide high quality care.
journal_name
J Psychosom Resjournal_title
Journal of psychosomatic researchauthors
Pabst S,Bertram A,Zimmermann T,Schiffer M,de Zwaan Mdoi
10.1016/j.jpsychores.2015.09.001subject
Has Abstractpub_date
2015-11-01 00:00:00pages
364-71issue
5eissn
0022-3999issn
1879-1360pii
S0022-3999(15)00538-3journal_volume
79pub_type
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journal_title:Journal of psychosomatic research
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journal_title:Journal of psychosomatic research
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更新日期:2012-01-01 00:00:00
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pub_type: 杂志文章
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