Abstract: TH-PO746
Nonadherence to Immunosuppressive Medications in Kidney Transplant Recipients: A Systematic Scoping Review
Session Information
- Transplantation: Clinical - 1
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Corr, Michael, Queen's University Belfast, Belfast, United Kingdom
- Walker, Andrew Ian Peter, Northern Ireland Foundation Programme, Belfast, United Kingdom
- Maxwell, Alexander P., Queen's University Belfast, Belfast, United Kingdom
- McKay, Gareth J., Queen's University Belfast, Belfast, United Kingdom
Background
Rejection and graft failure remain common in transplant recipients. Non-adherence to immunosuppressive medications is considered a major contributor to reduced long-term graft survival, particularly in younger people. Improved clinical practice based on adherence studies has been minimal. Our aim was to increase understanding of non-adherence to immunosuppressive medications following kidney transplantation and identify research gaps to inform future studies.
Methods
Joanna Briggs’ Institute Methodology used. MedlineALL, Embase, Web of Science Core Collection and Scopus databases searched January 2000 through December 2023. Abstract and full text review undertaken independently by two reviewers. Data collated using a pre-designed extraction tool.
Results
359 articles met the inclusion criteria. Non-adherence was commonly defined using self-reported questionnaires. Prevalence of non-adherence varied widely. There was little correlation between method of measurement and reported rates of non-adherence (Figure 1). Despite younger age being identified as a risk factor for non-adherence, reported prevalence did not differ significantly in studies reporting prevalence in children, adolescents, or young adults vs. older adults (33.5% vs. 34.0%). Interventional studies to improve adherence are heterogenous, often report small effects and limited by the lack of gold-standard methods to measure adherence.
Conclusion
Despite increasing research in the field, evidence to support measures to improve non-adherence in kidney transplant recipients remains weak. Future studies should consider a common definition of non-adherence to enable robust comparisons to be made e.g. using the Basel Assessment of Adherence to Immunosuppressive Medication Scale (BAASIS). We recommend validation of existing tools and interventions in larger cohorts rather than further single-centre studies to improve the evidence-base to address this important clinical problem.