The Role of Illness Perceptions, Treatment Beliefs and Goal Cognitions in Nonadherence After Kidney Transplantation

Abstract

The aim was to investigate the role of illness perceptions, treatment beliefs and goal cognitions in predicting medication adherence after kidney transplantation. Consecutive patients were invited to participate in an interview 6 weeks (T1: n=113), 6 months (T2: n=104) and 18 months (T3: n=87) after transplantation. The following concepts were measured: adherence (BAASIS©); illness perceptions (Brief IPQ); treatment beliefs (BMQ); goal cognitions (adapted from Pomaki); and socio-demographic and medical characteristics. Nonadherence significantly increased from 17%, 27%, to 31%. Controlling for T1 adherence, logistic regression showed that lower age and an increase in perceived graft longevity were related to nonadherence 6 months post-transplant (p<.05). Controlling for T1 and T2 adherence, a decrease in self-efficacy between T2 and T3 was significantly related to nonadherence 18 months post-transplant (p < .05). Various psychological factors were found to pertinent at different stages in the post-transplant period. Unrealistic beliefs and self-efficacy are potential targets for interventions aimed at reducing nonadherence after kidney transplant.