Introduction: Medication nonadherence is a leading cause of long-term graft failure in kidney transplantation (KT). Despite the introduction of various immunosuppressants and medications for chronic diseases, adherence remains challenging. The role of pharmacists in improving patients' understanding through medication counseling is underevaluated. This study investigated the impact of periodic counseling by pharmacists on the improvement of patients' medication adherence.
Methods: In this single-center prospective study at Korea University Anam Hospital, we started with 49 kidney transplant recipients from November 2020 to April 2021. Following the exclusion of 3 due to mortality, 46 patients remained. Transplant pharmacists conducted quarterly evaluations using the Immunosuppressive Therapy Adherence Scale (ITAS). Although initial non-adherence was observed in 20 patients at the 3-month mark, this number decreased to 4 by 12 months. For analysis purposes, 21 patients were selected based on changes in their adherence status throughout the year, ensuring a focused examination of adherence patterns.
Results: The ITAS results indicate an improvement in compliance over time, suggesting the effectiveness of educational interventions. Although no significant differences were noted in age or sex, the 'Non->non' group exhibited a more considerable fluctuation in creatinine levels and eGFR, indicating potential impacts on kidney function. Moreover, a higher rate of acute rejection was observed in this group, although the small sample size and associated statistical limitations should be considered when interpreting these results.
Conclusion: Periodic counseling by pharmacists may play a vital role in enhancing medication adherence in KT recipients, potentially improving graft outcomes. Despite the apparent stability in medication understanding across all cohorts, the positive trend in adherence highlights the need for continuous education and personalized medication management in transplant care.