Older Kidney Transplant Recipients More Adherent to Medications

Austin—There are few available data regarding health and its relationship to adherence to medications as it relates to age in recipients of kidney transplants. Marc Emos, MD, and colleagues at SUNY Downstate Medical Center, Brooklyn, New York, conducted face-to-face interviews with 16 long-term patients chosen at random from the outpatient transplant clinic at the center. A two-question survey was used to assess adherence; health perception was assessed with the Illness Perception Questionnaire-revised (IPQ-R) and a modified version of the Health Beliefs Questionnaire.

Results of the study were reported during a poster session at the NKF 2018 Spring Clinical Meetings. The poster was titled Relationship between Age, Health Beliefs, and Adherence in Kidney Transplant Recipients (KTRs).

Mean age of the participants was 50.5 years, time since transplant was 136 months, and creatinine level was 2.02 mg/dL. Forty percent of the cohort had income of more than $20,000 per year.

Age was related with agreement with the following statements:

  • If I see an excellent doctor regularly, I am less likely to have health problems (r=0.61; P<.05)
  • I can only maintain my health by consulting health professionals (r=0.5; P<.05).
  • The type of care I receive from other people is what is responsible for how well I recover from illness (r=0.5; P<.05)
  • My kidney transplant does not worry me (r=0.55; P=0.26)

Age was inversely related with agreement with the following statements:

  • There is nothing that can help my kidney transplant (r=–0.6; P<.05)
  • Having a kidney transplant makes me feel anxious (r=–0.714; P=.002).

For older patients, score on the IPQ-R scale was high for reliance on “powerful others.”

There was an association between older age and taking blood pressure medications (r=0.68; P=.013); there was an inverse association between older age and non-adherence overall (r=0.54; P=.037). There was no relationship between age and creatinine, estimated glomerular filtration rate, hemoglobin, albumin, or systolic or diastolic blood pressure.

“In our population, older patients were more likely to  believe that quality of care was important, scored higher on the “powerful others” component of the IPQ-R, and were less concerned about their transplant in general. Older patients reported better adherence to blood pressure medications according to schedule and adherence in general. Although there are concerns with transplanting older patients, better adherence, overall happiness with the transplant, and the tendency to rely on “powerful others” may give them an advantage in the long term,” the researchers concluded.

Source: Emos M, Limb J, Soomar R, et al. Relationship between age, health beliefs, and adherence in kidney transplant recipients (KTRs). Abstract of a poster presented at the National Kidney Foundation 2018 Spring Clinical Meetings, April 10-14, 2018, Austin, Texas.