Predicting adherence to immunosuppressant therapy: A prospective analysis of the theory of planned behaviour

Marie A. Chisholm, Gail M. Williamson, Charles E. Lance, Laura L. Mulloy

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

Abstract

Background. The objective of this study was to increase the ability to predict renal transplant patients (RTPs) who are most likely to be non-adherent to their immunosuppressant therapy (IST). Methods. One hundred and fifty-eight RTPs completed questionnaires assessing Theory of Planned Behaviour (TPB) variables (attitudes, subjective norms and perceived behavioural control) relevant to intentions to adhere to their IST, with the addition of a general measure of past adherence to medical advice. In the full sample, intentions to adhere to IST was the outcome variable. In a subsample of 70 RTPs, the primary outcome was IST adherence. Results. TPB variables (attitudes, β = 0.32, P< 0.01; perceived behavioural control, β 0.37, P <0.01; but not subjective norms, β 0.001, ns) explained 41% of the variance in intentions to adhere to IST (P < 0.001). Past behaviour predicted perceived behavioural control (β = 0.67, P < 0.001). Subsample analyses explained 33% (P < 0.001) of the variance in adherence, with intentions and past behaviour being the primary factors (P < 0.05). Conclusions. RTPs particularly at risk may be those who have a history of non-adherence to medical advice, especially when they have negative attitudes about IST adherence and feel they have little control over their medication-taking behaviour. Interventions to improve attitudes about IST adherence and control of adherence behaviour are needed.

Original languageEnglish (US)
Pages (from-to)2339-2348
Number of pages10
JournalNephrology Dialysis Transplantation
Volume22
Issue number8
DOIs
StatePublished - Aug 2007

Keywords

  • Adherence
  • Immunosuppressant medications
  • Renal transplant recipients

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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