Frequency and correlates of non-adherence in a large sample of adult patients after kidney transplantation: A cross-sectional KTx360° substudy

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2026-02-01 Epub Date: 2025-11-25 DOI:10.1016/j.jpsychores.2025.112474

Mariel Nöhre , Felix Klewitz , Maximilian Bauer-Hohmann , Eva Kyaw Tha Tun , Marietta Lieb , Yesim Erim , Uwe Tegtbur , Lena Schiffer , Lars Pape , Mario Schiffer , Martina de Zwaan

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引用次数: 0

Abstract

Objective

Non-adherence to immunosuppressive medication (ISM) is a common and preventable cause of graft loss after kidney transplantation (KTx). Adherence is a multifaceted construct influenced by various factors. Despite frequent reports linking non-adherence with multiple variables, results often seem contradictory. The lack of patient registers in Germany to encompass psychosocial aspects limits data to smaller, selective studies. The aim was to evaluate the frequency and correlates of non-adherence in a large sample of adult KTx patients.

Methods

This cross-sectional substudy was embedded within the structured follow-up program KTx360°. It took place at the transplant centers of Hannover Medical School, Hann. Münden and Erlangen in Germany between May 2017 and October 2020. 838 adult KTx patients participated in this substudy. Adherence was assessed using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS) alongside other sociodemographic, psychosocial, and medical variables.

Results

Participants had an average age of 52.3 years (SD = 13.5), with 58.7 % male. According to the BAASIS interview, 22.1 % reported non-adherence, mainly due to timing (13.0 %) and taking (11.7 %) non-adherence, with only 0.5 % ceasing at least one ISM. Factors linked to non-adherence in regression analysis included younger age, male gender, longer post-transplant time, and perceived medication overuse. The effect sizes were small. The informative value is limited by the design and the sample size.

Conclusion

In our cross-sectional analysis, nearly a quarter of the participants reported suboptimal adherence, mainly associated with primarily non-modifiable risk factors. Routine adherence assessments and targeted interventions are essential to improving long-term outcomes.

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肾移植后大样本成人患者不依从发生率及其相关因素：一项横断面KTx360°亚研究

目的：免疫抑制药物不依从性（ISM）是肾移植术后移植物丧失的一个常见且可预防的原因。依从性是一个受多种因素影响的多方面结构。尽管经常有报告将不遵医嘱与多个变量联系起来，但结果似乎往往是相互矛盾的。德国缺乏包括心理社会方面的患者登记，限制了数据规模较小的选择性研究。目的是评估大量成年KTx患者不依从性的频率和相关因素。方法本横断面亚研究纳入结构化随访计划KTx360°。实验在汉诺威医学院的移植中心进行。2017年5月至2020年10月期间在德国的梅恩登和埃尔兰根。838名成年KTx患者参与了本亚研究。使用巴塞尔免疫抑制药物依从性评估量表（basasis）以及其他社会人口统计学、社会心理和医学变量来评估依从性。结果参与者平均年龄52.3岁（SD = 13.5），男性占58.7%。根据basasis的访谈，22.1%的患者报告未依从性，主要是由于时间（13.0%）和服用（11.7%）未依从性，只有0.5%的患者至少停止了一次ISM。在回归分析中，与不依从性相关的因素包括年龄较小、男性、移植后时间较长和感知到的药物过度使用。效应量很小。信息价值受到设计和样本量的限制。在我们的横断面分析中，近四分之一的参与者报告了不理想的依从性，主要与主要不可改变的风险因素有关。常规依从性评估和有针对性的干预措施对于改善长期结果至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.