Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Dec 24, 2016; 6(4): 736-742
Published online Dec 24, 2016. doi: 10.5500/wjt.v6.i4.736
Psychological perspective of medication adherence in transplantation
Concetta De Pasquale, Massimiliano Veroux, Michele Fornaro, Nunzia Sinagra, Giusi Basile, Cecilia Gozzo, Roberta Santini, Alessandra Costa, Maria Luisa Pistorio
Concetta De Pasquale, Massimiliano Veroux, Michele Fornaro, Nunzia Sinagra, Giusi Basile, Cecilia Gozzo, Roberta Santini, Alessandra Costa, Maria Luisa Pistorio, Vascular Surgery and Organ Transplant Unit, Department of Medical, Surgery Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy
Author contributions: De Pasquale C and Pistorio ML contributed to study conception, design, and writing; Sinagra N, Basile G, Gozzo C, Santini R and Costa A contributed to data acquisition; Fornaro M contributed to data analysis and interpretation; Veroux M contributed to editing, reviewing, and final approval of the article.
Institutional review board statement: The study was reviewed and approved by the University of Catania Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: None of the authors declare any conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at depasqua@unict.it. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Concetta De Pasquale, MD, PhD, Vascular Surgery and Organ Transplant Unit, Department of Medical, Surgery Sciences and Advanced Technologies “GF Ingrassia,” University of Catania, Via Santa Sofia, 84, 95123 Catania, Italy. depasqua@unict.it
Telephone: +39-095-3782629 Fax: +39-095-3782629
Received: June 24, 2016
Peer-review started: June 27, 2016
First decision: August 11, 2016
Revised: September 13, 2016
Accepted: October 25, 2016
Article in press: October 27, 2016
Published online: December 24, 2016
Abstract
AIM

To identify the risk factors and the post-transplant psychological symptoms that affect adherence to therapy in a population of kidney transplant recipients.

METHODS

The study examined the psychological variables likely responsible for the non-adherent behavior using a psychological-psychiatric assessment, evaluation of the perception of patients’ health status, and an interview regarding the anti-rejection drug therapy assumption. The study included 74 kidney transplant recipients.

RESULTS

Individuals with a higher level of education and more years since transplantation showed better mental balance. Regarding gender, women appeared to be less adherent to therapy. Further, the years since transplantation adversely affected the proper pharmacological assumption. Adherence to therapy did not significantly change with the mental health index.

CONCLUSION

The biopsychosocial illness model provides a conceptual frame of reference in which biological, psychological, and social aspects take on the same importance in the adherence to treatment protocols. For effective management, it is necessary to understand the patients’ personal experiences, their assumptions about the disease, health status perception, and mood, and to identify any “barriers” that could cause them to become noncompliant.

Keywords: Transplantation, Adherence, Mental health, Psychological assessment, Psychiatric assessment

Core tip: Therapeutic Adherence after transplantation is of fundamental importance for the patient’s short- and long-term well-being and assumes a set of adaptations to a new lifestyle. The authors in this study analyzed the psychological characteristics of a sample of transplant recipients and different temperament styles, yet not studied in other research on transplantation. The results suggested that different temperaments influence in different ways the treatment compliance and showed that the transplant experience change behaviors and quality of life based on the personality and temperament characteristics. In conclusion, post-transplant psychological support positively affects adherence to treatment, and coping strategies of the subject.