Measuring compliance with drug regimens after renal transplantation: comparison of self-report and clinician rating with electronic monitoring

Transplantation. 2004 Mar 15;77(5):786-9. doi: 10.1097/


Nonadherence to immunosuppressants in renal transplant recipients is a major factor affecting graft survival, but it is difficult to detect accurately in clinical practice. Adherence was measured in 153 adult renal transplant recipients using self-report questionnaires and interview, clinician rating, and cyclosporine levels. The sensitivity and specificity of these measures were determined by comparison with electronic monitoring in a randomly selected subsample of 58 subjects. Measures of adherence in current clinical use do not perform well when tested against electronic monitoring. Self-report at a confidential interview was the best measure of adherence for the detection of both missed doses and erratic timing of medication. However, the use of a confidential interview is not directly applicable to a clinical setting. Further research on how best to facilitate disclosure in clinical settings may be the best way to develop adherence measures for use in routine practice.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cyclosporine / administration & dosage*
  • Cyclosporine / blood
  • Drug Monitoring / methods*
  • Female
  • Graft Rejection / drug therapy*
  • Graft Rejection / psychology
  • Humans
  • Immunosuppressive Agents / administration & dosage*
  • Immunosuppressive Agents / blood
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Patient Compliance*
  • Self Administration
  • Sensitivity and Specificity
  • Surveys and Questionnaires


  • Immunosuppressive Agents
  • Cyclosporine