Purpose: Our aim was to investigate the association between self-report measure and serum concentration fluctuation of immunosuppressive medication (IM) in renal transplant recipients in China and examine the relationship between post-transplantation time and IM adherence.
Methods: Renal transplant recipients at least 3 months post transplantation were recruited from a follow-up outpatient clinic. Both self-reported Morisky Medication Adherence Scale and serum concentration of IM (cyclosporine trough level and tacrolimus trough level) were used to measure drug adherence.
Findings: Two hundred and nine patients were recruited in the study. The majority of the patients received grafts from deceased donors (70.3%), were male (63.2%), and were married (83.3%). The nonadherence to IM was 31.7%, as measured by the Morisky Medication Adherence Scale. A statistically significant association between self-reported adherence and serum concentration fluctuation of tacrolimus trough level was identified (P < 0.001), but not for cyclosporine (P = 0.997). Serum concentration fluctuation of tacrolimus trough levels and self-report adherence of IM were associated with transplantation time (P < 0.001 and P = 0.003, respectively).
Implications: The Morisky Medication Adherence Scale appears valid in measuring drug adherence when compared with serum concentration fluctuation. Both self-report questionnaire and serum concentration fluctuation of tacrolimus changed with different post-transplantation time. These 2 measurements could be integrated into routine clinical practice for renal transplant recipients.
Keywords: MMAS-4; Morisky Medication Adherence Scale; adherence; immunosuppressive medication; renal transplantation; serum concentration.
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