Longitudinal Course and Baseline Predictors of Trajectories of Clinician-assessed Adherence to Immunosuppressant Medication in Patients after Kidney Transplantation: A KTx360° Substudy

作者：Martina de Zwaan, Mariel Nöhre, Felix Klewitz, Maximilian Bauer-Hohmann, Charlotte Kuczyk, Yeşim Erim, Lena E. Schiffer, Deborah Meier, Julia Katharina Wolff, Uwe Tegtbur, Lars Pape, Mario Schiffer · 发表于：Transplantation Direct · 年份：2025 · DOI：10.1097/txd.0000000000001813 · 被引用次数：3 · 研究领域：Renal Transplantation Outcomes and Treatments、Medication Adherence and Compliance、Dialysis and Renal Disease Management

Background: Optimal and maintained adherence to immunosuppressive medication is essential to kidney graft success. Methods: We analyzed the longitudinal course of immunosuppressant adherence as measured with the Basel Assessment of Adherence to Immunosuppressive Medication Scale interview for up to 3-y duration of the Kidney Transplantation 360° study. Additionally, we examined putative baseline predictors of adherence trajectories. During the investigation period, patients participated in a multidisciplinary aftercare program consisting of case management, psychosocial and exercise assessments and interventions, including telemedicine support. Results: The analysis sample with at least 1 valid information on the Basel Assessment of Adherence to Immunosuppressive Medication Scale consisted of 838 adult patients (41.3% women) aged 52.3 y (SD 13.5). Adherence to immunosuppressants improved significantly during the Kidney Transplantation 360° aftercare program; however, at each assessment point, 17%-25% of the patients still reported suboptimal adherence. Baseline predictors for a better improvement of adherence were younger age, male sex, and a longer duration since transplantation. Those variables were associated with a lower adherence at baseline, and we detected a "catch-up effect" over time, which might have been supported by the comprehensive aftercare program. Conclusions: We believe that our aftercare program has supported the "catch-up effect" in adherence in younger ma...