Improved Adherence to Tacrolimus Once-Daily Formulation in Renal Recipients
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- 1 January 2013
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Transplantation
- Vol. 95 (2), 333-340
- https://doi.org/10.1097/tp.0b013e3182725532
Abstract
With effective agents available to prevent posttransplantation acute organ rejection, medication adherence becomes a key factor for successful treatment outcomes after renal transplantation. A once-daily, modified-release oral formulation of tacrolimus has been developed to simplify dosing and improve medication adherence. Adherence Measurement in Stable Renal Transplant Patients Following Conversion From Prograft to Advagraf is a randomized multicenter controlled trial to evaluate adherence between a tacrolimus once-daily regimen and a tacrolimus twice-daily regimen using an electronic monitor to document drug intake. After enrolment, all patients continued the twice-daily regimen for 3 months and then were randomized 2:1 between the two formulations and followed for 6 months. Adherence was decomposed into patients' persistence and implementation of each regimen. Two hundred nineteen patients (45% male; 3±2 years after transplantation) were analyzed (145 once daily and 74 twice daily). At 6 months after randomization, 81.5% of the once-daily group and 71.9% of the twice-daily group remained persistent with the treatment (P=0.0824). Among patients who remained engaged with the regimen, 88.2% of the once-daily group and 78.8% of the twice-daily group (P=0.0009) took the prescribed number of daily doses. When the patients took the twice-daily regimen, the average percentage of missed doses was 11.7% in the morning and 14.2% in the evening (P=0.0035). Regimen implementation of tacrolimus once daily is significantly superior to the twice-daily regimen. There was a residual prevalence of suboptimal adherence that will have to be countered by means other than reformulation and regimen simplification. Electronically compiled dosing histories provide detailed data on patient adherence that can be used for efficient medication management.This publication has 33 references indexed in Scilit:
- Immunosuppressant Therapy Adherence and Graft Failure Among Pediatric Renal Transplant RecipientsAmerican Journal of Transplantation, 2009
- Transplant Outcomes and Economic Costs Associated with Patient Noncompliance to ImmunosuppressionAmerican Journal of Transplantation, 2009
- Adherence to the immunosuppressive regimen in pediatric kidney transplant recipients: A systematic reviewPediatric Transplantation, 2009
- Quantitative Patterns of Azathioprine Adherence After Renal TransplantationTransplantation, 2009
- Associations of Characteristics of Renal Transplant Recipients With Clinicians’ Perceptions of Adherence to Immunosuppressant TherapyTransplantation, 2007
- A Retrospective Analysis of Immunosuppression Compliance, Dose Reduction and Discontinuation in Kidney Transplant RecipientsAmerican Journal of Transplantation, 2007
- Acute rejection in non-compliant renal allograft recipients: a distinct morphologyClinical Transplantation, 2007
- Rates and Risk Factors for Nonadherence to the Medical Regimen After Adult Solid Organ TransplantationTransplantation, 2007
- Supporting medication adherence in renal transplantation (SMART): a pilot RCT to improve adherence to immunosuppressive regimensClinical Transplantation, 2006
- Race and Electronically Measured Adherence to Immunosuppressive Medications after Deceased Donor Renal TransplantationJournal of the American Society of Nephrology, 2005