Adherence to Immunosuppressive Drugs in Kidney Transplant Recipients and Factors Associated with Adherence

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Cheeratikarn Phithakham
Nutjaree Suttitong
Thanisa Kritsadathan
Nuttapong Chailungkar
Naruemon Suyayai
Chalongrat Manoree
Kajohnsak Noppakun


Background: Medication adherence is crucial after organ transplantation. Adherence to immunosuppressive drugs in kidney transplant recipients is lowest among organ transplant patients.
Objective: To evaluate adherence to immunosuppressive drugs among kidney transplant recipients and determine factors associated with adherence.
Material and method: A cross-sectional study was conducted from December 2018 to January 2019 at the kidney transplant clinic, Maharaj Nakorn Chiang Mai Hospital. Kidney transplant recipients were interviewed by clinical pharmacists using the immunosuppressant therapy adherence instrument (ITAS). Data was analyzed using descriptive statistics, and compared between the adherence group (ITAS ≥10) and the non-adherence group (ITAS ≤9) using student t-test, Mann-Whitney U test and Fisher’s exact test.
Results: A total of 224 kidney transplant recipients participated in the study. The mean age was 47.9±14.7 years, of which 146 (65.2%) were male. One hundred and twenty-eight cases (57.1%) were educated below the level of higher education and 180 cases (80.4%) were under the care of a live-in caregiver. The median time of transplantation was 48 months (interquartile range 20-91). Most patients (84.8%) took tacrolimus once daily, followed by prednisolone once daily (63.8%), and mycophenolate sodium more than once a day (61.6%). Based on the ITAS scores, 210 (93.8%) patients had good adherence to immunosuppressive drugs. There was not any different factors between the adherence group and the non-adherence group.
Conclusion: Most kidney transplant recipients (93.8%) had good adherence to immunosuppressive drugs. Specific characteristics related to adherence could not be identified among the factors studied.


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Phithakham, C. ., Suttitong, N. ., Kritsadathan, T., Chailungkar, N. ., Suyayai, . N. ., Manoree, C., & Noppakun, K. (2023). Adherence to Immunosuppressive Drugs in Kidney Transplant Recipients and Factors Associated with Adherence. Lampang Medical Journal, 43(2), 60–70. Retrieved from
Original Article


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