Prevalence of Medication Nonadherence to Co-medication Compared to Immunosuppressants in Heart Transplant Recipients: Findings From the International Cross-sectional BRIGHT Study

Abstract Purpose To assess and compare the prevalence of medication nonadherence (MNA) (implementation and persistence) to immunosuppressantsand co-medications in heart transplantrecipients. Methods MNA prevalence was assessed using the Basel Assessment of Adherence to ImmunosuppressiveMedications Scale (self-report) and compared using logistic regression in a 4-continent sample of 1397 heart transplantrecipients from 36 heart transplantcenters in 11 countries. Findings MNA was significantly (α = 0.05) higher to co-medications than to immunosuppressants(taking nonadherence: 23.9% vs 17.3%; odds ratio [OR] = 1.5; 95% CI, 1.30–1.73; drug holiday: 5.7% vs 1.9%; OR = 3.17; 95% CI, 2.13–4.73; dose alteration: 3.8% vs 1.6%; OR = 2.46; 95% CI, 1.49–4.06; and discontinuation: 2.6% vs 0.5%; OR = 5.15; 95% CI, 2.36–11.20). Implications The observed MNA necessitates adherence-enhancing interventions encompassing the entire post– heart transplantmedication regimen. ClinicalTrials.gov identifier: NCT01608477 .