Abstract

Health outcomes of transplantation require strict medication compliance. Non-compliance with immunosuppressive medications after renal transplantation is considered to be a major cause of graft rejection and loss. There are diverse reasons for non-compliance, including: lack of financial resources, lack or perceived severity of consequences, health and religious beliefs, social support, disease characteristics, medication adverse effects, and treatment complexity. A systematic review of the literature on medical non-compliance after renal transplantation was carried out to identify factors leading to non-compliant behavior among renal transplant recipients (RTRs) to prevent graft loss. The aim was to highlight commonalities facilitating the clinicians identify patients for early intervention. It is found that recipients at a higher risk of noncompliance after renal transplants were younger, female, unmarried, recipients of living donor transplants and had been transplanted for a longer time with a history of a previous transplant. Findings also suggested that psychosocial factors such as stress, depression, lack of coping skills and avoidant behaviors, lack of perceived control on health out comes, locus of control attributed to powerful others, lack of perceived social and family support, and low self-efficacy were significant predictors of non-compliance. Significance of compliant behavior after renal transplantation, reasons for non-compliance and its relationship to organ loss are discussed.