Self-Reported Adherence to Medical Prescriptions before and after Liver Transplantation: A Longitudinal Study

Aim: The aim of this study was to evaluate adherence to medical regimen in patients before and after LT. Materials and methods: patients with liver cirrhosis who were referred to our Multivisceral Transplant Unit for LT evaluation (2006-2008) were enrolled. LT patients were followed up at 6 and 12 months after LT. All patients underwent anonymous questionnaire and blood tests before. Results: 134 patients (100 M, mean age 53.3 y) were enrolled. Before LT 44%, 13% and 13% of patients were non adherent to therapy, to outpatient visit and to blood tests, respectively. Non adherent patients vs. good adherent patients were younger (p=0.04) and unmarried (p=0.03). Being divorced and having a better MELD score at LT were independent risk factors for non adherence before LT. 50 out of 134 (%) patients underwent LT during the study period. At 6 months after LT 12%, 16% and 10% of patients were non adherent to therapy, to outpatient visit and to blood tests, respectively. Non adherent vs. good adherent patients had better MELD at LT (p=0.04). At 12 months after LT 34%, 44% and 42% of patients were non adherent to therapy, to outpatient visit and to requested blood tests, respectively, signifi cantly worse compared to 6 months evatuation. Non adherent vs. good adherent patients, had better MELD at LT (p=0.03), and reported >3 side effects of IS (p=0.02). 48% of patients with poor adherence after LT, had poor adherence before LT. Conclusions: Adherence to medical regimen is poor in cirrhotic patients being the risk factors to be divorced and having good liver function. It seems that adherence improves in the short-term, but deteriorates again in the longer time after LT, when being relatively stable at LT and experiencing side effects due to IS are associated with poor adherence. Educational programs for such patients are badly needed.