Predicting adherence to immunosuppressant therapy: A prospective analysis of the theory of planned behaviour

Marie A. Chisholm; Gail M. Williamson; Charles E. Lance; Laura L. Mulloy

doi:10.1093/ndt/gfm149

Predicting adherence to immunosuppressant therapy: A prospective analysis of the theory of planned behaviour

Marie A. Chisholm
, Gail M. Williamson
, Charles E. Lance
, Laura L. Mulloy

Research output: Contribution to journal › Article › peer-review

64 Scopus citations

Abstract

Background. The objective of this study was to increase the ability to predict renal transplant patients (RTPs) who are most likely to be non-adherent to their immunosuppressant therapy (IST). Methods. One hundred and fifty-eight RTPs completed questionnaires assessing Theory of Planned Behaviour (TPB) variables (attitudes, subjective norms and perceived behavioural control) relevant to intentions to adhere to their IST, with the addition of a general measure of past adherence to medical advice. In the full sample, intentions to adhere to IST was the outcome variable. In a subsample of 70 RTPs, the primary outcome was IST adherence. Results. TPB variables (attitudes, β = 0.32, P< 0.01; perceived behavioural control, β 0.37, P <0.01; but not subjective norms, β 0.001, ns) explained 41% of the variance in intentions to adhere to IST (P < 0.001). Past behaviour predicted perceived behavioural control (β = 0.67, P < 0.001). Subsample analyses explained 33% (P < 0.001) of the variance in adherence, with intentions and past behaviour being the primary factors (P < 0.05). Conclusions. RTPs particularly at risk may be those who have a history of non-adherence to medical advice, especially when they have negative attitudes about IST adherence and feel they have little control over their medication-taking behaviour. Interventions to improve attitudes about IST adherence and control of adherence behaviour are needed.

Original language	English (US)
Pages (from-to)	2339-2348
Number of pages	10
Journal	Nephrology Dialysis Transplantation
Volume	22
Issue number	8
DOIs	https://doi.org/10.1093/ndt/gfm149
State	Published - Aug 1 2007
Externally published	Yes

Funding

Acknowledgements. This research was partially funded by the Carlos and Marguerite Mason Trust Fund (M. A. C., principal investigator). Participation in this research was facilitated by a grant from the National Institute on Aging (AG15321, G. M. W., principal investigator; C. E. L., co-investigator) and by a fellowship from the Institute for Behavioral Research at the University of Georgia (G. M. W.). All of the authors listed had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analyses.

Funders	Funder number
National Institute of Aging	R01AG015321
Georgia Advanced Computing Resource Center, University of Georgia
Carlos and Marguerite Mason Trust

Keywords

Adherence
Immunosuppressant medications
Renal transplant recipients

ASJC Scopus subject areas

Nephrology
Transplantation

Access to Document

10.1093/ndt/gfm149

Cite this

@article{86b9066f99554da994d274a030f1f36c,

title = "Predicting adherence to immunosuppressant therapy: A prospective analysis of the theory of planned behaviour",

abstract = "Background. The objective of this study was to increase the ability to predict renal transplant patients (RTPs) who are most likely to be non-adherent to their immunosuppressant therapy (IST). Methods. One hundred and fifty-eight RTPs completed questionnaires assessing Theory of Planned Behaviour (TPB) variables (attitudes, subjective norms and perceived behavioural control) relevant to intentions to adhere to their IST, with the addition of a general measure of past adherence to medical advice. In the full sample, intentions to adhere to IST was the outcome variable. In a subsample of 70 RTPs, the primary outcome was IST adherence. Results. TPB variables (attitudes, β = 0.32, P< 0.01; perceived behavioural control, β 0.37, P <0.01; but not subjective norms, β 0.001, ns) explained 41\% of the variance in intentions to adhere to IST (P < 0.001). Past behaviour predicted perceived behavioural control (β = 0.67, P < 0.001). Subsample analyses explained 33\% (P < 0.001) of the variance in adherence, with intentions and past behaviour being the primary factors (P < 0.05). Conclusions. RTPs particularly at risk may be those who have a history of non-adherence to medical advice, especially when they have negative attitudes about IST adherence and feel they have little control over their medication-taking behaviour. Interventions to improve attitudes about IST adherence and control of adherence behaviour are needed.",

keywords = "Adherence, Immunosuppressant medications, Renal transplant recipients",

author = "Chisholm, \{Marie A.\} and Williamson, \{Gail M.\} and Lance, \{Charles E.\} and Mulloy, \{Laura L.\}",

note = "Funding Information: Acknowledgements. This research was partially funded by the Carlos and Marguerite Mason Trust Fund (M. A. C., principal investigator). Participation in this research was facilitated by a grant from the National Institute on Aging (AG15321, G. M. W., principal investigator; C. E. L., co-investigator) and by a fellowship from the Institute for Behavioral Research at the University of Georgia (G. M. W.). All of the authors listed had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analyses.",

year = "2007",

month = aug,

day = "1",

doi = "10.1093/ndt/gfm149",

language = "English (US)",

volume = "22",

pages = "2339--2348",

journal = "Nephrology Dialysis Transplantation",

issn = "0931-0509",

publisher = "Oxford University Press",

number = "8",

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T1 - Predicting adherence to immunosuppressant therapy

T2 - A prospective analysis of the theory of planned behaviour

AU - Chisholm, Marie A.

AU - Williamson, Gail M.

AU - Lance, Charles E.

AU - Mulloy, Laura L.

N1 - Funding Information: Acknowledgements. This research was partially funded by the Carlos and Marguerite Mason Trust Fund (M. A. C., principal investigator). Participation in this research was facilitated by a grant from the National Institute on Aging (AG15321, G. M. W., principal investigator; C. E. L., co-investigator) and by a fellowship from the Institute for Behavioral Research at the University of Georgia (G. M. W.). All of the authors listed had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analyses.

PY - 2007/8/1

Y1 - 2007/8/1

N2 - Background. The objective of this study was to increase the ability to predict renal transplant patients (RTPs) who are most likely to be non-adherent to their immunosuppressant therapy (IST). Methods. One hundred and fifty-eight RTPs completed questionnaires assessing Theory of Planned Behaviour (TPB) variables (attitudes, subjective norms and perceived behavioural control) relevant to intentions to adhere to their IST, with the addition of a general measure of past adherence to medical advice. In the full sample, intentions to adhere to IST was the outcome variable. In a subsample of 70 RTPs, the primary outcome was IST adherence. Results. TPB variables (attitudes, β = 0.32, P< 0.01; perceived behavioural control, β 0.37, P <0.01; but not subjective norms, β 0.001, ns) explained 41% of the variance in intentions to adhere to IST (P < 0.001). Past behaviour predicted perceived behavioural control (β = 0.67, P < 0.001). Subsample analyses explained 33% (P < 0.001) of the variance in adherence, with intentions and past behaviour being the primary factors (P < 0.05). Conclusions. RTPs particularly at risk may be those who have a history of non-adherence to medical advice, especially when they have negative attitudes about IST adherence and feel they have little control over their medication-taking behaviour. Interventions to improve attitudes about IST adherence and control of adherence behaviour are needed.

AB - Background. The objective of this study was to increase the ability to predict renal transplant patients (RTPs) who are most likely to be non-adherent to their immunosuppressant therapy (IST). Methods. One hundred and fifty-eight RTPs completed questionnaires assessing Theory of Planned Behaviour (TPB) variables (attitudes, subjective norms and perceived behavioural control) relevant to intentions to adhere to their IST, with the addition of a general measure of past adherence to medical advice. In the full sample, intentions to adhere to IST was the outcome variable. In a subsample of 70 RTPs, the primary outcome was IST adherence. Results. TPB variables (attitudes, β = 0.32, P< 0.01; perceived behavioural control, β 0.37, P <0.01; but not subjective norms, β 0.001, ns) explained 41% of the variance in intentions to adhere to IST (P < 0.001). Past behaviour predicted perceived behavioural control (β = 0.67, P < 0.001). Subsample analyses explained 33% (P < 0.001) of the variance in adherence, with intentions and past behaviour being the primary factors (P < 0.05). Conclusions. RTPs particularly at risk may be those who have a history of non-adherence to medical advice, especially when they have negative attitudes about IST adherence and feel they have little control over their medication-taking behaviour. Interventions to improve attitudes about IST adherence and control of adherence behaviour are needed.

KW - Adherence

KW - Immunosuppressant medications

KW - Renal transplant recipients

UR - https://www.scopus.com/pages/publications/34547830304

UR - https://www.scopus.com/pages/publications/34547830304#tab=citedBy

U2 - 10.1093/ndt/gfm149

DO - 10.1093/ndt/gfm149

M3 - Article

C2 - 17442741

AN - SCOPUS:34547830304

SN - 0931-0509

VL - 22

SP - 2339

EP - 2348

JO - Nephrology Dialysis Transplantation

JF - Nephrology Dialysis Transplantation

IS - 8

ER -

Predicting adherence to immunosuppressant therapy: A prospective analysis of the theory of planned behaviour

Abstract

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Keywords

ASJC Scopus subject areas

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