Cognitive and Psychosocial Predictors of Immunosuppressive Medication Nonadherence in Adult Liver Transplant Recipients

Claire Dunphy, Fordham University

Abstract

Nonadherence to immunosuppressive (IS) medication following liver transplant has consistently been associated with poor health outcomes, yet nonadherence is common. Although numerous attempts have been made to develop effective interventions for patients who have difficulty adhering to their IS medications, no “gold standard” intervention approach exists. The development of effective, targeted interventions first requires additional research about risk for IS nonadherence. A number of possible sociodemographic, psychosocial, and other risk factors for nonadherence have been identified in the literature, but there is no clear consensus about which specific patient characteristics confer risk of nonadherence and subsequent poor health outcomes in this population. The aim of this study was to identify cognitive and psychosocial predictors of IS medication nonadherence and graft rejection in a diverse population of adult liver transplant recipients, using the MLVI as an objective measure of adherence. Nearly half of the participants in this sample demonstrated nonadherence. None of the cognitive or psychosocial variables of interest (i.e., age, subjective social status, social support, psychological distress, health literacy, and problem solving) were significantly associated with IS adherence. Poorer health literacy was associated with greater psychological distress. Higher perceived social status was associated with higher social support and less psychological distress.

Subject Area

Clinical psychology|Medicine|Surgery

Recommended Citation

Dunphy, Claire, "Cognitive and Psychosocial Predictors of Immunosuppressive Medication Nonadherence in Adult Liver Transplant Recipients" (2021). ETD Collection for Fordham University. AAI28717205.
https://research.library.fordham.edu/dissertations/AAI28717205

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