Drug Adherence, in Liver Transplant, Patients: A Review

Abstract

Transplantation of liver due to liver failure provides the chance to patient to live in pleasant environment and improve their health-related quality of life. The therapeutic objectives of liver transplant only be achieved if the patient becomes adherent to the therapy prescribed by the doctors such as Immunosuppressant drugs and life style as suggested. Endurance of the liver transplant patients in the starting five years after the liver transplant varies from 60-80%. The survival depends upon type of illness which leads to liver transplantation the causative agents including comorbidities, carelessness in liver damaging diseases and fails to manage self-life care. The major risk after transplantation, are the organ dysfunction and the graft failure. Therefore, the outcomes of transplant will not be achieved if the patient become non adherent to therapy on the other hand cost will also increased. Non adherence can be determined by interaction with patients to know the different factors that involves in non-adherence such as health care system of the patient, socio economic condition of the patient, availability of prescribed medicines, underlying disease and medical condition of the patient. Patient is said to be adherent if the patient taking 80-110% medicines according to prescription. In case of liver transplantation non adherence may vary from 2-67% and the annual average estimated as 35.6%, as a result graft rejection or failure in transplantation may occurs, cost of treatment may also increase and morbidity and mortality may also increase. There are different tools used to determine non adherence some of them are counting the number of tablets, self-reported questionnaire, reporting of common side effects of immunosuppressive drugs, determination of serum level of immunosuppressant drugs and electronic monitoring. Out of these methods the most common, easy and cost-effective method for assessing the non-adherence in medical practice is self-reporting. Self-reporting method is highly specific because the questionnaire used in this, contain specific questions it is also used with other tools to get the specific information of patient’s medication use behavior. Medication Adherence among Liver Transplant Recipients can be improved by application of reminder approaches such as Phone Calls, Mobile Application and/or Patient Counseling and medication non-adherence have negative impact on quality of life of patients.