RESEARCH ARTICLE


Adherence in Adolescent and Young Adult Kidney Transplant Recipients



J. Foster Bethany1, *, L.H. Pai Ahna2
1 Montreal Children’s Hospital & McGill University, Canada
2 Cincinnati Children’s Hospital Medical Center & University of Cincinnati College of Medicine, Canada


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©Foster and Pai; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Montreal Children' s Hospital, Division of Nephrology, E-222, 2300 Tupper Street, Montreal, QC H3H 1P3, Canada; Tel.: 514-412-4461; Fax: 514-412-4359; E-mail: Bethany.foster@mcgill.ca


Abstract

Poor adherence to immunosuppressive medications may be the most important barrier to long term graft survival. An understanding of medication adherence and its determinants is critical to addressing this important problem. In this paper, we will review the different ways in which adherence may be compromised, summarize the evidence that young people constitute a particularly high risk group, and consider the consequences and impact of poor adherence. We will also review the determinants of adherence, including characteristics of the patient and family, the treatment regimen, the healthcare team and its organization, and the healthcare system. We will highlight the most common barriers to adherence identified by young people, and consider different methods of measuring adherence, along with the advantages and limitations of each. Finally, we will consider possible intervention strategies to improve adherence in young people.

Keywords: adolescence, compliance, emerging adulthood, pediatric, renal transplant..