Therapeutic Adherence in Kidney Transplanted Adolescents

Abstract

Introduction: Medication adherence affects the prognosis of kidney transplant recipients, since it is a determinant factor for the risk of rejection and loss of renal graft. Adolescence is a stage where many factors can influence therapeutic adherence, including cognitive development, emotional issues and family dysfunction.
The objective of this study was to evaluate therapeutic adherence in adolescents ≥ 12 years‐old who were submitted to kidney transplant and are currently being followed at a Pediatric Kidney Transplantation Center.

Methods: Collection of demographic and clinical data; application of the Treatment Adherence Measure Questionnaire, between June and August 2022.

Results: There were 28 adolescents being followed. All responded to the questionnaire. The median time between transplant and questionnaire was 80 months.

Nine adolescents (32%) answered that they had already forgotten to take medication and 16 (57%) had been careless with the time of the medication. Only 11 adolescents (38%) answered that they have always complied with treatment. Of the patients who responded that they had already forgotten to take their medication, it was found that 6/9 (67%) had infra‐therapeutic tacrolimus levels detected at least once and 3/9 (33%) had acute graft dysfunction. Of the patients who responded that they always adhered to therapy, it was found that only 1 (5%) had infra‐therapeutic tacrolimus levels, without criteria for acute graft dysfunction.

Conclusion: Non‐adherence to therapy is frequent in adolescents submitted to kidney transplant. It is crucial to develop strategies focused on adolescents to improve understanding of the disease and raise awareness of the importance of treatment adherence.