Kidney transplantation remains the best and most cost-effective treatment for patients with end stage kidney disease, and the number of kidney transplants performed in the U.S. annually has increased steadily since 2015. To ensure transplant success, kidney transplant recipients (KTRs) are often prescribed lifelong, complex medication regimens that include immunosuppressants, anti-infectives, and medications to control comorbid chronic conditions. Taking these medications as prescribed is essential, as nonadherence can lead to significant complications. Overall, KTRs face significant health burdens, and must be confident, and competent, in their ability to manage a range of conditions and self-care behaviors, including medication-taking. Using data and accessing participants from a large clinical trial, we applied mixed methods to address gaps in the transplant literature related to medication regimen adherence and self-management of health among adult KTRs. In doing so, we sought to (1) characterize medication nonadherence among KTRs; (2) understand KTR experiences of medication-taking; and (3) evaluate the impact of the COVID-19 pandemic on KTRs’ ability to self-manage their health. We found evidence of both immediate and downstream barriers to regimen adherence, patient- and health system-level barriers to adherence, and barriers to which minority KTRs might be particularly vulnerable. Importantly, our findings indicated that adherence to medications taken for comorbid conditions might prove more difficult for KTRs than adherence to immunosuppressants. We also found that the pandemic might have challenged KTRs’ ability to manage their health by compromising access to necessary care, including vaccination in the early stages of eligibility, and by exacerbating rates of anxiety. Based on our findings, we provide recommendations – both within and outside the context of the ongoing pandemic – to support KTRs in engaging in critical health behaviors like appropriate medication-taking.

Creator

• Balakrishnan, Aparna

DOI

• https://doi.org/10.21985/n2-rzjc-0n07

Subject

• Public health

Language

• en

Alternate Identifier

• http://dissertations.umi.com/northwestern:16248
• etdadmin_upload_928487

Keyword

• COVID-19
• Post-transplant Experience
• Medication Adherence
• Kidney Transplant
• Health Management
• Mixed Methods

Date created

• 2022-01-01

Resource type

• Dissertation

Rights statement

• In Copyright