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Factors relevant to medication non-adherence in kidney transplant: a systematic review

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Abstract

Background Medication non-adherence is a major issue after transplant that can lead to misdiagnosis, rejection, poor health affecting quality of life, graft loss or death. Several estimations of adherence and related factors have previously been described but conclusions leave doubt as to the most accurate assessment method. Aim of the review To identify the factors most relevant to medication non-adherence in kidney transplant in current clinical practice. Method This systematic review is registered in the PROSPERO data base and follows the Prisma checklist. Articles in English in three databases from January 2009 to December 2014 were analysed. A synthesis was made to target adherence assessment methods, their prevalence and significance. Results Thirty-seven studies were analysed rates of non-adherence fluctuating from 1.6 to 96%. Assessment methods varied from one study to another, although self-reports were mainly used. It appears that youth (≤50 years old), male, low social support, unemployment, low education, ≥3 months post graft, living donor, ≥6 comorbidities, ≥5 drugs/d, ≥2 intakes/d, negative beliefs, negative behavior, depression and anxiety were the factors significantly related to non-adherence. Conclusion As there are no established guidelines, consideration should be given to more than one approach to identify medication non-adherence although self-reports should remain the cornerstone of adherence assessment.

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Acknowledgements

The authors thank Alexandra Tavernier (M.A, University of Glasgow, UK; Professeur Agrégée, University of Lille, France) for reading and editing the manuscript.

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Authors and Affiliations

  1. Institut de pharmacie, CHU Lille, 59000, Lille, France

    Stephanie Belaiche, Bertrand Décaudin & Pascal Odou

  2. Service des Maladies de l’appareil digestif et de la Nutrition, CHU Lille, 59000, Lille, France

    Sébastien Dharancy

  3. Service de Néphrologie, CHU Lille, 59000, Lille, France

    Christian Noel & Marc Hazzan

  4. EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, Univ. Lille, 59000, Lille, France

    Stephanie Belaiche, Bertrand Décaudin & Pascal Odou

  5. Inserm U995 - LIRIC - Lille Inflammation Research International Center, Univ. Lille, 59000, Lille, France

    Sébastien Dharancy, Christian Noel & Marc Hazzan

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  1. Stephanie Belaiche
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Belaiche, S., Décaudin, B., Dharancy, S. et al. Factors relevant to medication non-adherence in kidney transplant: a systematic review. Int J Clin Pharm 39, 582–593 (2017). https://doi.org/10.1007/s11096-017-0436-4

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