TY - JOUR
T1 - Gender differences in medication adherence among adolescent and young adult kidney transplant recipients
AU - Boucquemont, Julie
AU - Pai, Ahna L.H.
AU - Dharnidharka, Vikas R.
AU - Hebert, Diane
AU - Furth, Susan L.
AU - Foster, Bethany J.
N1 - Funding Information:
The authors declare no conflicts of interest to disclose, except Dr. Foster, who is a co-investigator on 2 investigator-initiated studies funded by Astellas Canada. The study was funded by the American National Institutes of Health, National Institutes of Diabetes, Digestive and Kidney diseases (NIDDK; R01DK092977). The funder had no role in study design, data collection, analysis, interpretation of data, writing the report, or and the decision to submit the report for publication. J.B., who was a postdoctoral fellow at the Research Institute of the McGill University Health Centre when this study was done, was supported by an RI MUHC—Desjardins Studentship in Child Health Research. B.J.F., a member of the Research Institute of the McGill University Health Centre, was supported by a Fonds de recherche du Quebec Santé Chercheur-Boursier Clinicien award. All authors participated in research design, in the writing of the article, and in data analysis. Correspondence: Bethany J. Foster, 1001 Decarie Blvd Montreal, QC, Canada H4A 3J1. (bethany.foster@mcgill.ca).
Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Background. Among kidney transplant recipients, gender differences in medication adherence may contribute to higher graft failure risks observed in girls and young women compared with boys and young men. Our aim was to determine whether adherence differs by gender, and whether gender differences vary by age in adolescent and young adult kidney transplant recipients. Methods. We examined data from the 3-month run-in period (no intervention) of the randomized Teen Adherence in Kidney transplant Effectiveness of Intervention trial. Adherence was monitored using electronic pillboxes in 136 patients (11-24 y) followed in 8 transplant centers in Canada and the United States. We used ordinal logistic regression with generalized estimating equations to estimate the association between gender and each of daily taking (proportion of prescribed doses taken) and timing (proportion of prescribed doses taken on time) adherence, considering effect modification by age (11-16 y vs 17-24 y). Results. No difference in taking adherence was observed by gender among participants aged 11 to 16 years (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.55-1.54), whereas among participants aged 17 to 24 years, women had significantly greater odds of higher taking adherence scores (OR, 3.03; 95% CI, 1.20-7.66) than men. Results were similar for timing adherence, with no difference among participants aged 11 to 16 years (OR, 1.03; 95% CI, 0.65-1.63) but a greater odds of higher timing adherence scores in women than in men among participants aged 17 to 24 years (OR, 3.26; 95% CI, 1.43-7.45). There were no differences in adherence assessed by self-report or SD of tacrolimus trough levels. Conclusions. Gender differences in adherence vary by age. Whereas younger adolescents show no adherence differences by gender, young women show much better adherence than young men.
AB - Background. Among kidney transplant recipients, gender differences in medication adherence may contribute to higher graft failure risks observed in girls and young women compared with boys and young men. Our aim was to determine whether adherence differs by gender, and whether gender differences vary by age in adolescent and young adult kidney transplant recipients. Methods. We examined data from the 3-month run-in period (no intervention) of the randomized Teen Adherence in Kidney transplant Effectiveness of Intervention trial. Adherence was monitored using electronic pillboxes in 136 patients (11-24 y) followed in 8 transplant centers in Canada and the United States. We used ordinal logistic regression with generalized estimating equations to estimate the association between gender and each of daily taking (proportion of prescribed doses taken) and timing (proportion of prescribed doses taken on time) adherence, considering effect modification by age (11-16 y vs 17-24 y). Results. No difference in taking adherence was observed by gender among participants aged 11 to 16 years (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.55-1.54), whereas among participants aged 17 to 24 years, women had significantly greater odds of higher taking adherence scores (OR, 3.03; 95% CI, 1.20-7.66) than men. Results were similar for timing adherence, with no difference among participants aged 11 to 16 years (OR, 1.03; 95% CI, 0.65-1.63) but a greater odds of higher timing adherence scores in women than in men among participants aged 17 to 24 years (OR, 3.26; 95% CI, 1.43-7.45). There were no differences in adherence assessed by self-report or SD of tacrolimus trough levels. Conclusions. Gender differences in adherence vary by age. Whereas younger adolescents show no adherence differences by gender, young women show much better adherence than young men.
UR - http://www.scopus.com/inward/record.url?scp=85057961805&partnerID=8YFLogxK
U2 - 10.1097/TP.0000000000002359
DO - 10.1097/TP.0000000000002359
M3 - Article
C2 - 29994983
AN - SCOPUS:85057961805
SN - 0041-1337
VL - 103
SP - 798
EP - 806
JO - Transplantation
JF - Transplantation
IS - 4
ER -