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Journal of Transplantation
Volume 2014 (2014), Article ID 675301, 9 pages
Research Article

Attitudes to Medication after Kidney Transplantation and Their Association with Medication Adherence and Graft Survival: A 2-Year Follow-Up Study

1Department of Internal Medicine, Erasmus Medical Centre, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
2Institute of Health Policy & Management (iBMG), Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
3Department of Hospital Pharmacy, Erasmus Medical Centre Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands

Received 13 November 2013; Revised 3 April 2014; Accepted 3 April 2014; Published 28 April 2014

Academic Editor: Gaetano Ciancio

Copyright © 2014 Mirjam Tielen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Nonadherence to medication is a common problem after kidney transplantation. The aim of this study was to explore attitudes towards medication, adherence, and the relationship with clinical outcomes. Method. Kidney recipients participated in a Q-methodological study 6 weeks after transplantation. As a measure of medication adherence, respondents completed the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS©-interview). Moreover, the intrapatient variability in the pharmacokinetics of tacrolimus was calculated, which measures stability of drug intake. Data on graft survival was retrieved from patient records up to 2 years after transplantation. Results. 113 renal transplant recipients (19–75 years old) participated in the study. Results revealed three attitudes towards medication adherence—attitude 1: “confident and accurate,” attitude 2: “concerned and vigilant,” and attitude 3: “appearance oriented and assertive.” We found association of attitudes with intrapatient variability in pharmacokinetics of tacrolimus, but not with self-reported nonadherence or graft survival. However, self-reported nonadherence immediately after transplantation was associated with lower two-year graft survival. Conclusion. These preliminary findings suggest that nonadherence shortly after kidney transplantation may be a risk factor for lower graft survival in the years to follow. The attitudes to medication were not a risk factor.