Dr Ronan Carrol and colleagues from England assessed adherence to medication after liver transplantation.
The team conducted a retrospective audit involving 435 patients of the Scottish national database who received transplants before 2003.
The researchers assessed the psychological factors implicated in poor adherence.
Adherence was assessed by attendance at follow-up clinic appointments, blood immunosuppressant levels, and episodes of cellular rejection.
The researchers found that attendance and immunosuppressant levels were often suboptimal.
The team noted that nonadherence may have contributed to retransplantation and death.
Cellular rejection after 6 months was associated with higher mortality.
|The greater the emotional impact of the transplant, the less adherent the patients|
Explanations as to why liver transplant patients may not take their medication as recommended were then explored.
The researchers conducted a detailed psychological assessments of 33 liver transplant recipients.
The research team indicated that low self-reported patient adherence was related to greater concerns regarding the potential adverse effects of medication.
Low self-reported patient adherence was related to a stronger belief that medicines in general are harmful.
In addition, the team found that the greater the effect or emotional impact the transplantation had on patients' lives, the less adherent patients were likely to be.
Dr Carrol's team comments, “The results highlight potential areas that, if confirmed in a larger study, might be targeted in a psychological intervention to improve patient adherence and thereby transplantation outcomes.”