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Posted 04.28.06

Kidney Transplant Recipients 'Lax' About Taking Anti-Rejection Medicine, Research Finds

MU Researcher Looking for Predictors and Interventions to Keep Recipients Healthy

COLUMBIA, Mo. -- The wait for a kidney transplant is long; the amount of time spent taking medications to make sure the body doesn't reject the organ is even longer. However, as many as 25 out of every 100 recipients are lax about taking their prescribed medications. Now, a nursing researcher at the University of Missouri-Columbia is studying medication adherence of kidney transplant recipients to ascertain the consequences of missing doses and develop intervention methods.

A unique pill bottle is the key to the research. Cindy Russell, assistant professor in the MU Sinclair School of Nursing, uses the Medication Event Monitoring System (MEMS). The MEMS bottle has a microchip in the cap to record the date and time the cap is removed in order to document when medication is taken. The information is downloaded and charted on a computer. Russell said this method is much more accurate than simply asking patients to describe how they take their medicine or blood tests, which tend to overestimate the amount of medication a person takes. Russell also is following medication adherence and its effect on the kidney health.

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"With this information, we hope to find characteristics that could predict potential problems and develop intervention methods that would help keep kidney transplant patients as healthy as possible and extend the life of their new kidneys and their lives overall," Russell said.

Early results of the study show four groups of medication-taking practices: people who take the medication regularly as prescribed, people who have a few late or missed doses, people who rarely take the medication on time with many late or missed doses, and people who miss a lot of doses. According to Russell, there were two surprises in the early results: People with a marginal social support system did fairly well with taking their medication and time wasn't a factor.

"We expected the amount of time that had passed since the transplant to make a difference in medication adherence, but we didn't see that," Russell said.

The medications have many strong side effects and are very expensive. Russell said that can be challenging for people who must take the medications twice a day to keep their kidney in good health.

Russell presented her early findings this month at the 2006 National Kidney Foundation Clinical Meeting in Chicago, IL. The research is a collaborative effort and is funded by the National Institutes for Health, national Kidney Foundation, American Nurses Association/Sigma Theta Tau and the MU Research Council.



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