Renal transplant patient compliance with free immunosuppressive medications

Marie A. Chisholm, Leslie J. Vollenweider, Laura L Mulloy, Muralidharan Jagadeesan, James J. Wynn, Holly E. Rogers, William E. Wade, Joseph T. DiPiro

Research output: Contribution to journalArticle

115 Citations (Scopus)

Abstract

Background. Noncompliance with immunosuppressive medications after renal transplantation is believed to be a major cause of allograft rejection and graft loss, with the impressive costs of these agents considered a significant reason for noncompliance. Our purpose was to determine the compliance rates of renal transplant patients who received their immunosuppressant therapy free of charge and evaluate their patterns of compliance. Methods. All patients who received a renal transplant and received their immunosuppressant medications at our institution for their first year posttransplant were included in the study. Compliance rate was calculated and serum immunosuppressant concentrations were obtained to validate compliance assessments. Results. Eighteen patients were included in the study. Approximately 48% of noncompliant patients were found to have subtarget drug concentrations, although only 14% of compliant patients had subtarget levels (x2=12.9, P<0.001). At 5 months posttransplant, 95% of the patients remained compliant; however, by 12 months posttransplant, only 48% of the patients remained compliant. The mean time to the first non-compliant month was 9.8 months (95% confidence intervals=8.60-11.0). Conclusions. Patients who received their immunosuppressants free of charge were generally compliant within their first year of transplantation, however, compliance tended to decrease over time. This suggests that drug cost alone does not explain noncompliant behavior. Intensive efforts to increase medication compliance before month 8 posttransplantation should be implemented.

Original languageEnglish (US)
Pages (from-to)1240-1244
Number of pages5
JournalTransplantation
Volume70
Issue number8
DOIs
StatePublished - Oct 27 2000

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Immunosuppressive Agents
Patient Compliance
Transplants
Kidney
Compliance
Drug Costs
Medication Adherence
Graft Rejection
Kidney Transplantation
Allografts
Transplantation
Confidence Intervals
Costs and Cost Analysis
Serum
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Transplantation

Cite this

Chisholm, M. A., Vollenweider, L. J., Mulloy, L. L., Jagadeesan, M., Wynn, J. J., Rogers, H. E., ... DiPiro, J. T. (2000). Renal transplant patient compliance with free immunosuppressive medications. Transplantation, 70(8), 1240-1244. https://doi.org/10.1097/00007890-200010270-00020

Renal transplant patient compliance with free immunosuppressive medications. / Chisholm, Marie A.; Vollenweider, Leslie J.; Mulloy, Laura L; Jagadeesan, Muralidharan; Wynn, James J.; Rogers, Holly E.; Wade, William E.; DiPiro, Joseph T.

In: Transplantation, Vol. 70, No. 8, 27.10.2000, p. 1240-1244.

Research output: Contribution to journalArticle

Chisholm, MA, Vollenweider, LJ, Mulloy, LL, Jagadeesan, M, Wynn, JJ, Rogers, HE, Wade, WE & DiPiro, JT 2000, 'Renal transplant patient compliance with free immunosuppressive medications', Transplantation, vol. 70, no. 8, pp. 1240-1244. https://doi.org/10.1097/00007890-200010270-00020
Chisholm MA, Vollenweider LJ, Mulloy LL, Jagadeesan M, Wynn JJ, Rogers HE et al. Renal transplant patient compliance with free immunosuppressive medications. Transplantation. 2000 Oct 27;70(8):1240-1244. https://doi.org/10.1097/00007890-200010270-00020
Chisholm, Marie A. ; Vollenweider, Leslie J. ; Mulloy, Laura L ; Jagadeesan, Muralidharan ; Wynn, James J. ; Rogers, Holly E. ; Wade, William E. ; DiPiro, Joseph T. / Renal transplant patient compliance with free immunosuppressive medications. In: Transplantation. 2000 ; Vol. 70, No. 8. pp. 1240-1244.
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