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Factors Affecting Compliance to Calcineurin Inhibitors Among Solid Organ Transplant Recipients

Hong Kong Society of Transplantation. Background Treatment compliance is an important factor that can affect the long term outcome of allograft. Data in this part of the world is lacking. Aim A self administered opinion survey on drug compliance of local organ transplant recipients was conducted to understand factors affecting adherence to calcineurin inhibitor (CNI) medication among transplant patients in Hong Kong. Methods With the help of various local patients support group, solid organ transplant patients aged over 18 years, or parents of organ transplant patients aged below 18 years, were invited to reply a self-administered questionnaire. Information on patient demographics, habit of taking transplant medicines, personal lifestyle as well as eating habits were collected. Factors affecting drug compliance and patient's knowledge on medication was analyzed. Results 579 questionnaires were received with a response rate of 40.1%. Respondents reported taking a median of 6 types of medicine currently each day. Forty eight percent of respondents reported taking CNIs without being on an empty stomach in the previous one month. The most common reasons cited were incompatibility with personal lifestyle (43%) and irregular meal schedules because of work (25%). Adherence to CNIs was especially lower on weekends than on weekdays, and it was also lower for the evening dose than in the morning. This was found to be related with their personal lifestyle factors as well as eating-out schedules. Seventy six percent of respondents were aware of an increased risk of transplant rejection if having poor treatment compliance, 46.2% were aware of a reduction in organ transplant survival rate, and 20.8% were aware of an increased risk of infection when taking CNIs without following doctors’ instructions closely. Conclusion Compliance to CNI medication is an ongoing issue among transplant patients in Hong Kong. Improving patient education, switching to a simpler drug regimen, providing digital tools to prompt correct dosing and electronic monitoring are potential strategies to improve treatment compliance to CNI medication. Hong Kong Transplant Sports Association. Hong Kong Liver Transplant Patients Association. Renal patient support group of Queen Elizabeth Hopsital, Princess Margaret Hospital, United Christian Hospital. Tuen Mun Hospital of Hong Kong.