Behavioral measures to reduce non-adherence in renal transplant recipients: a prospective randomized controlled trial.
Garcia MF, Bravin AM, et al.Int Urol Nephrol 2015; 47(11):1899-90
Aims
To evaluate the impact of an educational program on the treatment adherence of kidney transplant recipients.
Interventions
Patients randomized to the control group received only the usual transplant education by the medical team as part of routine post-transplant care, while the treatment group received an additional intervention program delivered by a healthcare professional consisting of ten weekly 30 minute education sessions.
Participants
111 renal transplant patients aged >21 years
Outcomes
The primary outcome measured was adherence to the use of immunosuppressant drugs via the Immunosuppressant Therapy Adherence Scale (ITAS). Renal function, serum levels and biopsy-proven acute rejection were also measured.
Follow-up
12 months
CET Conclusions
This is an interesting study from Brazil in which patients who had received a renal transplant were randomised to receive usual education after transplantation or usual education plus ten additional weekly thirty-minute education/counselling sessions about immunosuppressive drugs and related changes. Treatment adherence was assessed using a specially designed questionnaire three months after transplantation and, in addition, renal function and the incidence of renal transplant rejection were recorded over twelve months. The non-adherence rates were high according to the way they were measured, namely 46% in the control group versus 15% in the treatment group. The relative risk for non-adherence was 2.59 times higher in the control group, there were no differences detected in renal function and rejection rates between the two groups. Only patients over 21 were entered into the study and the definition of non-compliance was quite rigid. Nevertheless, this educational strategy directed at the patients’ perception and knowledge about immunosuppressive drugs did improve the short term adherence to these drugs. As noncompliance is a major problem after renal transplantation, the authors are to be commended on this study and perhaps further studies with longer term follow-up are required.
Data analysis
Per protocol analysis
Trial registration
Not described