Abstract: FR-PO1178
Can Pretransplant Psychosocial Factors Predict Racial Difference in Post-Transplant Adherence?
Session Information
- Transplantation: Clinical - Immunosuppression, Adherence, Outcomes
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Ng, Yue-Harn, University of New Mexico, Albuquerque, New Mexico, United States
- Litvinovich, Igor, University of New Mexico, Albuquerque, New Mexico, United States
- Ford, Christopher Graham, University of New Mexico, Albuquerque, New Mexico, United States
- Zhu, Yiliang, University of New Mexico, Albuquerque, New Mexico, United States
- Dew, Mary amanda, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
- Puttarajappa, Chethan M., University of Pittsburgh, Pittsburgh, Pennsylvania, United States
- Shapiro, Ron, Recanati/Miller Transplantation Institute, New York, New York, United States
- Unruh, Mark L., University of New Mexico, Albuquerque, New Mexico, United States
- Myaskovsky, Larissa, University of New Mexico, Albuquerque, New Mexico, United States
Background
The success of a kidney transplant (KT) relies on patients’ ability to adhere to a complex medical regimen and routine follow up post-transplant. Non-adherence is common post-transplant and is a leading cause of allograft loss. In this study, we aimed to identify non-medical factors at the time of initial KT evaluation that predicted racial difference in non-adherence post-transplant.
Methods
We performed a prospective cohort study of patients who underwent initial KT evaluation, received a KT and were interviewed at 6 months post-transplant. We collected data on baseline demographics, medical, cultural, psychosocial and transplant related factors. We quantified adherence to each medication within the first 6 months post KT (immunosuppressants and anti-hypertensives) with a Likert scale ranging from never to daily missing of medications and used the average of the individual scores as a continuous outcome variable. We then built multiple linear regression models using variables with effect estimates ≥0.2 and p-values <0.1 in bivariate analyses to identify factors that predicted adherence.
Results
1152 patients were enrolled in the initial study, 149 patients underwent KT and had ≥6 months follow up; 123(82.55%) were White, 84(56.38%) were male and 103(69.13%) were age >45; adherence scores ranged from 1-7 [mean(SD)=6.8(0.78)]. African American race predicted lower adherence, even after accounting for cultural, psychosocial and transplant factors. Age > 45 and having public insurance predicted greater adherence(Table 1).
Conclusion
African American race was a significant risk factor for post-transplant non-adherence. Data from this study showed that cultural and psychosocial factors did not affect this association.
Funding
- Commercial Support – Dialysis Clinic Inc