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Person-Level Correlates of Nonadherence to Co-Medication in Spanish Heart Transplant Recipients

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Crespo-Leiro M.G.
  • Pérez-Castro T.R.
  • Segura-Saint-Gerons C.
  • Brossa-Loidi V.
  • Segovia-Cubero J.
  • Naya-Leira C.
  • López-Granados A.
  • Gil-Alonso D.
  • Briceño-Hinojo A.
  • Muñiz J.
  • Grille-Cancela Z.
  • Denhaerynck K.
  • De Geest S.

Grupos

Abstract

Background: Nonadherence to heart transplantation-related medications involves both immunosuppressant drugs and co-medications; yet the correlates of heart transplantation patients’ overall medication nonadherence remain unclear. Objectives: We aimed to (1) describe nonadherence to both immunosuppressive and co-medication among Spanish heart transplantation patients, (2) to identify individual-level predictors of co-medication nonadherence, and (3) to describe nonadherence to non-pharmacological advice (eg, sun protection, physical activity, alcohol use) and clinical practice patterns of transplant centers. Methods: For this multicenter cross-sectional study, we surveyed 224 adult patients attending 5 Spanish centers 1 to 5 years post-transplantation. We assessed nonadherence to immunosuppressants and co-medications using the Basel Assessment of Adherence to Immunosuppressive Medication Scale (BAASIS©). Correlates of nonadherence to co-medications were derived from the Integrative Model of Behavioral Prediction using self-report instruments, as were non-pharmacological treatment adherence and treatment centers’ practice patterns. Supported by causal mapping, multiple logistic regression analysis allowed adjustment for relevant confounders. Results: Nonadherence prevalence was 16.5% for co-medications (range across centers: 7.4%-25.0%), versus 9.4% (range: 2.6%-22.2%) for immunosuppressants. Adherence support varied across centers. Barriers to immunosuppressant nonadherence predicted co-medication nonadherence (odds ratio = 11.80; 95% CI, 2.59-53.69). Nonadherence to non-pharmacological treatments, particularly sunscreen use (59.3%) and physical activity (31.8%), were also common. Conclusions: Post-heart transplantation co-medication nonadherence surpasses immunosuppressant nonadherence. Barriers to immunosuppressant adherence strongly predict co-medication nonadherence. While no direct causal relationship is clear, immunosuppressant nonadherence may prove useful for identifying patients prone to co-medication nonadherence. © The Author(s) 2026

Datos de la publicación

ISSN/ISSNe:
0193-9459, 1552-8456

WESTERN JOURNAL OF NURSING RESEARCH  SAGE PUBLICATIONS INC

Tipo:
Article
Páginas:
468-478
PubMed:
41902698
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
0,528 SCImago ℠
Cuartil:
Q2 SCImago ℠

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Keywords

  • Adult; Aged; Cross-Sectional Studies; Female; Heart Transplantation; Humans; Immunosuppressive Agents; Male; Medication Adherence; Middle Aged; Spain; Surveys and Questionnaires; Transplant Recipients; immunosuppressive agent; adult; aged; clinical trial; cross-sectional study; female; graft recipient; heart transplantation; human; male; medication compliance; middle aged; multicenter study; psychology; questionnaire; Spain

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