Nonadherence with immunosuppressive drugs

US compared with European kidney transplant recipients

Kris Denhaerynck, Ariane Desmyttere, Fabienne Dobbels, Philip Moons, Jim Young, Bonita Siegal, Stuart M. Greenstein, Jürg Steiger, Yves Vanrenterghem, Jean Paul Squifflet, Johannes P. Van Hooff, Sabina De Geest

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background-System factors increasingly are suggested as important yet understudied correlates of nonadherence.Objective-To explore the relationship between healthcare system and prevalence of nonadherence with immunosuppressive regimen by studying variation in non-adherence between European and US kidney transplant recipients and as well as nonadherence in European countries.Methods-We performed a secondary data analysis on data collected in 3 independent cross-sectional studies using comparable methodology including patients from the United States, the Netherlands, Belgium, and Switzerland. Nonadherence was measured using 1 item of the Siegal questionnaire. Patients were categorized as nonadherent if they reported missing a dose of immunosuppression in the last 4 weeks. Analyses were performed by multiple mixed logistic regression, with center as a random effect and clinical and demographical differences between groups as fixed effects.Results-1563 US and 614 European patients from 3 different countries (Belgium [n=187], the Netherlands [n=85], and Switzerland [n=342]) were included. Prevalence of nonadherence in the United States and Europe was 19.3% and 13.2.%, respectively. This higher nonadherence in US patients was confirmed in a multiple logistic regression analysis (OR=1.78; 95% CI, 1.10-2.89). Nonadherence differed between Belgium (16%) and the Netherlands (14.1%) (OR=0.27; 95% CI, 0.09-0.80) and between Belgium and Switzerland (11.4%; OR=0.17; 95% CI, 0.0-0.42).Conclusion- This is the first study showing differences in prevalence of nonadherence between European and US patients and among European patients. Further research should aim at unraveling the dynamics explaining these differences.

Original languageEnglish (US)
Pages (from-to)206-214
Number of pages9
JournalProgress in Transplantation
Volume16
Issue number3
StatePublished - Sep 1 2006

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Immunosuppressive Agents
Belgium
Kidney
Switzerland
Pharmaceutical Preparations
Netherlands
Logistic Models
Immunosuppression
Transplant Recipients
Cross-Sectional Studies
Regression Analysis
Delivery of Health Care
Research

ASJC Scopus subject areas

  • Transplantation

Cite this

Denhaerynck, K., Desmyttere, A., Dobbels, F., Moons, P., Young, J., Siegal, B., ... De Geest, S. (2006). Nonadherence with immunosuppressive drugs: US compared with European kidney transplant recipients. Progress in Transplantation, 16(3), 206-214.

Nonadherence with immunosuppressive drugs : US compared with European kidney transplant recipients. / Denhaerynck, Kris; Desmyttere, Ariane; Dobbels, Fabienne; Moons, Philip; Young, Jim; Siegal, Bonita; Greenstein, Stuart M.; Steiger, Jürg; Vanrenterghem, Yves; Squifflet, Jean Paul; Van Hooff, Johannes P.; De Geest, Sabina.

In: Progress in Transplantation, Vol. 16, No. 3, 01.09.2006, p. 206-214.

Research output: Contribution to journalArticle

Denhaerynck, K, Desmyttere, A, Dobbels, F, Moons, P, Young, J, Siegal, B, Greenstein, SM, Steiger, J, Vanrenterghem, Y, Squifflet, JP, Van Hooff, JP & De Geest, S 2006, 'Nonadherence with immunosuppressive drugs: US compared with European kidney transplant recipients', Progress in Transplantation, vol. 16, no. 3, pp. 206-214.
Denhaerynck K, Desmyttere A, Dobbels F, Moons P, Young J, Siegal B et al. Nonadherence with immunosuppressive drugs: US compared with European kidney transplant recipients. Progress in Transplantation. 2006 Sep 1;16(3):206-214.
Denhaerynck, Kris ; Desmyttere, Ariane ; Dobbels, Fabienne ; Moons, Philip ; Young, Jim ; Siegal, Bonita ; Greenstein, Stuart M. ; Steiger, Jürg ; Vanrenterghem, Yves ; Squifflet, Jean Paul ; Van Hooff, Johannes P. ; De Geest, Sabina. / Nonadherence with immunosuppressive drugs : US compared with European kidney transplant recipients. In: Progress in Transplantation. 2006 ; Vol. 16, No. 3. pp. 206-214.
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AU - Siegal, Bonita

AU - Greenstein, Stuart M.

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N2 - Background-System factors increasingly are suggested as important yet understudied correlates of nonadherence.Objective-To explore the relationship between healthcare system and prevalence of nonadherence with immunosuppressive regimen by studying variation in non-adherence between European and US kidney transplant recipients and as well as nonadherence in European countries.Methods-We performed a secondary data analysis on data collected in 3 independent cross-sectional studies using comparable methodology including patients from the United States, the Netherlands, Belgium, and Switzerland. Nonadherence was measured using 1 item of the Siegal questionnaire. Patients were categorized as nonadherent if they reported missing a dose of immunosuppression in the last 4 weeks. Analyses were performed by multiple mixed logistic regression, with center as a random effect and clinical and demographical differences between groups as fixed effects.Results-1563 US and 614 European patients from 3 different countries (Belgium [n=187], the Netherlands [n=85], and Switzerland [n=342]) were included. Prevalence of nonadherence in the United States and Europe was 19.3% and 13.2.%, respectively. This higher nonadherence in US patients was confirmed in a multiple logistic regression analysis (OR=1.78; 95% CI, 1.10-2.89). Nonadherence differed between Belgium (16%) and the Netherlands (14.1%) (OR=0.27; 95% CI, 0.09-0.80) and between Belgium and Switzerland (11.4%; OR=0.17; 95% CI, 0.0-0.42).Conclusion- This is the first study showing differences in prevalence of nonadherence between European and US patients and among European patients. Further research should aim at unraveling the dynamics explaining these differences.

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