Association between day of the week and medication adherence among adolescent and young adult kidney transplant recipients
Disruption of usual routines may hinder adherence, increasing the risk of rejection. We aimed to compare weekend versus weekday medication adherence among adolescent and young adult kidney transplant recipients, hypothesizing poorer adherence on weekends. We examined data from the Teen Adherence in Kidney transplant Effectiveness of Intervention Trial (TAKE-IT). We assessed the 3-month run-in period (no intervention) and the 12-month intervention interval, considering a potential interaction between weekend/weekday and treatment group. Adherence was monitored using electronic pillboxes in participants 11-24 years followed in eight transplant centers in Canada and the United States. We used logistic regression with generalized estimating equations to estimate the association between weekends/weekdays and each of perfect taking (100% of prescribed doses taken) and timing (100% of prescribed doses taken on time) adherence. Taking (OR = 0.72 [95% CI 0.65-0.79]) and timing (OR = 0.66 [95% CI 0.59-0.74]) adherence were poorer on weekends than weekdays in the run-in (136 participants) and the intervention interval (taking OR = 0.74 [0.67-0.81] and timing OR = 0.71 [95% CI 0.65-0.77]). There was no interaction by treatment group (64 intervention and 74 control participants). Weekends represent a disruption of regular routines, posing a threat to adherence. Patients and families should be encouraged to develop strategies to maintain adherence when routines are disrupted. TAKE-IT registration number: Clinicaltrials.gov registration: NCT01356277 (May 17, 2011).
Reviewer: | Dr Liset Pengel, Centre for Evidence in Transplantation, Nuffield Department of Surgical Sciences University of Oxford |
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Conclusion: | This is a post-hoc analysis of the Teen Adherence in Kidney transplant Effectiveness of Intervention Trial (TAKE-IT) which showed that participants in the intervention arm had significantly greater odds of taking prescribed medications and taking medications at or near the prescribed time compared to the control group (https://www.transplantlibrary.com/article/29602631). The post-hoc analysis reviewed whether medication adherence differs by day of the week and included 138 adolescent and young adult kidney transplant recipients. Data showed that taking adherence (100% adherence) and on-time dosing (100% timing adherence) was less likely on weekends than weekdays but there was no difference by treatment group. The authors suggest that the change in routine between weekdays and weekends causes poor adherence on weekends. |
Aims: | This post-hoc analysis of the Teen Adherence in Kidney transplant Effectiveness of Intervention Trial (TAKE-IT) aimed to investigate whether adolescent and young adult renal transplant patients had poorer medication adherence during weekends in comparison to weekdays. |
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Interventions: | Participants in the TAKE-IT trial were randomly assigned to either the adherence-promoting intervention group, or the control group where adherence was not discussed. |
Participants: | 138 kidney transplant patients aged 11 to 24 years. |
Outcomes: | The main outcomes of interest were the proportion of prescribed doses administered (taking adherence), and the proportion of prescribed doses administered within a period of 1 hour before to 2 hours after the dosing time prescribed (timing adherence). |
Follow Up: | 12 months |
Funding: | Non-industry funding |
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Publication type: | Randomized Controlled Trial, Randomised Controlled Trial |
Trial registration: | ClinicalTrials.gov - NCT01356277 |
Organ: | Kidney |
Language: | English |
Author email: | bethany.foster@mcgill.ca |
MeSH terms: | Adolescent; Adult; Child; Early Medical Intervention; Female; Follow-Up Studies; Humans; Immunosuppressive Agents; Kidney Failure, Chronic; Kidney Transplantation; Male; Medication Adherence; Patient Education as Topic; Prognosis; Prospective Studies; Research Design; Time Factors; Young Adult; 0 (Immunosuppressive Agents) |