Ask the Doctor
Questions about kidney disease? Risk factors? Signs and symptoms? Are you concerned about yourself, a friend or family member? Ask Dr. Spry.
By Tracy Anderson-Haag, PharmD
A question for our transplant recipients: When is the last time you missed a dose of your medications? Can you remember being late taking your medications? Do you find yourself forgetting to take a dose of your immunosuppressive or other medications?
Most transplant patients are taking between 5 and 15 medications daily, with doses due one to four times daily. This is a very complicated medication regimen! It is not surprising that 20-60% of transplant patients report missing medication doses or non-adherence to their medication regimen. Unfortunately, these missed doses or forgotten medications can lead to serious problems in transplant patients including acute rejection, chronic transplant damage and ultimately the failure of a transplant.
With so much at stake, why is non-adherence to medications so common after transplant? There are many reasons. The most frequent reason given for missing medication doses is “I forgot.” Intense medication regimens required after transplant are difficult to manage and remembering to take pills two or three times a day can be a challenge while trying to maintain a good quality of life. Additionally, immunosuppressive medications prevent rejection and transplant patients do not necessarily feel a beneficial effect when they take their medications. In fact, sometimes the side effects of the medications make you feel worse! These medication side effects may include pain or tingling in the hands or feet, tremors, cosmetic changes like weight gain or hair growth or gastrointestinal problems like nausea or diarrhea. Intolerable side effects are commonly blamed for patients missing doses or stopping medications all together. Another concern is cost. Medications to prevent rejection and treat other complications common in transplant patients often carry a high price tag. Patients may be forced to pick and choose which medications they can afford at their pharmacy.
What can we do to improve compliance with medications?
Remember, transplant recipients are the most important player on the post-transplant team. If unable to comply with their medication regimen, outcomes will not be satisfactory for the patient or the health care team. Good communication between the players including your health care providers and social workers can improve patient compliance, outcomes and quality of life