AUTHOR=Wang Yiman , Veltkamp Denise M. J. , van der Boog Paul J. M. , Hemmelder Marc H. , Dekker Friedo W. , de Vries Aiko P. J. , Meuleman Yvette 

TITLE=Illness Perceptions and Medication Nonadherence to Immunosuppressants After Successful Kidney Transplantation: A Cross-Sectional Study

JOURNAL=Transplant International

VOLUME=Volume 35 - 2022

YEAR=2022

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2022.10073

DOI=10.3389/ti.2022.10073

ISSN=1432-2277

ABSTRACT=Background: Medication nonadherence to immunosuppressants is a well-known risk factor for suboptimal health outcomes in kidney transplant recipients (KTRs). This study examined the relationship between illness perceptions and medication nonadherence in prevalent Dutch KTRs and whether this relationship depended on post-transplant time .
Methods: Eligible KTRs transplanted in Leiden University Medical Center were invited  for this cross-sectional study. The illness perceptions and medication nonadherence were measured via validated questionnaires. Associations between illness perceptions and medication nonadherence were investigated using multivariable logistic regression models. 
Results: 627 participating KTRs were analyzed. 203 (32.4%) KTRs were considered nonadherent to their immunosuppressants with ‘taking medication more than 2 hours from the prescribed dosing time’ as the most prevalent nonadherent behaviour (n=171; 27.3%). Three illness perceptions were significantly associated with medication nonadherence: illness identity (adjusted odds ratio [ORadj]=1.07; 95% confidence interval [CI], 1.00-1.14), concern (ORadj=1.07; 95%CI,1.00-1.14), and illness coherence (ORadj=1.11; 95%CI,1.01-1.22). The relationships between illness perceptions and medication nonadherence did not differ depending on post-transplant time (p-values ranged from 0.48 to 0.96).
Conclusion: Stronger negative illness perceptions are associated with medication nonadherence to immunosuppressants. Targeting negative illness perceptions by means of psychoeducational interventions could optimize medication nonadherence and consequently improve health outcomes in KTRs.