DOI: 10.5176/2251-3833_GHC15.26

Authors: Sha Teng, Wenxin Zhang, Xiao Peng, Yabin Shang, Xiaohong Lin and Hongxia Liu*

Abstract:

Objective: Kidney transplant recipients require lifelong treatment with immunosuppressive medications to avoid graft rejection and graft loss. Symptoms experienced may influence recipients’ perceived quality of life and medication adherence. The purpose of this study were to evaluate the symptoms experience associated with immunosuppressive medications in adult kidney transplant recipients who had been followed up for at least one year and to explore the association between the symptom experience and adherence to immunosuppressive medications. Methods: A convenient sample of 231 recipients with a follow up of at least one year after kidney transplantation was included in a general hospital in China. Symptom experience associated with immunosuppressive medications was measured by the 13 Item Symptom Experience of Immunosuppressive-related Side Effects Scale. Self-reported adherence to immunosuppressive medications was assessed using Adherence with Immunosuppressive Medication Scale. Ridit analysis was used to rank symptom distress items. Results: Totally 60.6{6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465} of recipients were male; the time after kidney transplantation was arbitrarily divided into a short-term cohort (1- to 4- years) and a long-term cohort (4- to 16- years) according to the median duration follow-up (4 years). Hypertension, hair loss, fatigue were the three most distressing symptoms over all items of whole sample. Hypertension was the most distressing symptom for cohort 1-4 years and cohort 4-16 years. For men hypertension was the most distressing symptom whereas for women hair loss was the most. Recipients in cohort 4-16 years were perceived a higher level of symptom distress compared with cohort 1-4 years, especially in increased hair growth and difficulty falling asleep. A negative relationship was found between symptom distress and adherence to immunosuppressive medications (r=-0.541, p=0.000). Conclusion: Recipients in cohort 4-16 years were perceived a higher level of symptom distress compared with cohort 1-4 years, especially in increased hair growth and difficulty falling asleep. No significant difference was found between gender groups. Recipients who reported a higher level of symptom distressing were more likely to be non-adherent. When healthcare provider develop and prescribe immunosuppressive medications, they should take the perception of recipients refer to side effects of immunosuppressive medications into consideration. And discussing the symptoms distress with recipients help healthcare provider to identify the recipients who at risk of medication non-adherence.

Keywords: kidney transplantation; symptom distress; immunosuppressive medications

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