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Association between day of the week and medication adherence among adolescent and young adult kidney transplant recipients.

Authors
  • Boucquemont, Julie1
  • Pai, Ahna L H2, 3
  • Dharnidharka, Vikas R4, 5
  • Hebert, Diane6
  • Zelikovsky, Nataliya7
  • Amaral, Sandra7, 8
  • Furth, Susan L7, 8
  • Foster, Bethany J1, 9, 10
  • 1 Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada. , (Canada)
  • 2 Center for Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
  • 3 Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
  • 4 Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri.
  • 5 St. Louis Children's Hospital, St. Louis, Missouri.
  • 6 Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada. , (Canada)
  • 7 Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
  • 8 Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania.
  • 9 Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada. , (Canada)
  • 10 Department of Pediatrics, McGill University, Montreal, Quebec, Canada. , (Canada)
Type
Published Article
Journal
American Journal of Transplantation
Publisher
Wiley (Blackwell Publishing)
Publication Date
Sep 10, 2019
Identifiers
DOI: 10.1111/ajt.15590
PMID: 31507087
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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). © 2019 The American Society of Transplantation and the American Society of Transplant Surgeons.

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