Assessment of Tacrolimus Adherence in Kidney Transplant Patients at Ahmed Gasim Hospital, Khartoum, Sudan (2022–2023)

Abstract

Background: Adherence to the immunosuppressant agents is essential for reducing graft rejection. Several tools have been investigated to determine the adherence level of different medications, and the simplified medication adherence questionnaire (SMAQ) is considered one such tool, especially for tacrolimus. This study assesses adherence levels toward tacrolimus use in kidney transplant patients (KTPs). Methods: This descriptive cross-sectional study was conducted at the Clinic of Nephrology, Ahmed-Gasim Hospital, Sudan, where a total of 166 KTPs responded to the questionnaire in the follow-up clinic, and those participants were treated with the immunosuppressant agent (tacrolimus). Statistical analysis was performed using the Statistical Package of Social Sciences (SPSS, version 27.0). Results: Out of the 166 responders, 157 (94.6%) exerted a high level of adherence, and 9 (5.4%) were nonadherent. Among different factors related to the low adherence level, forgetfulness (n = 22; 13.3%) was a significant factor. Patient’s age (years), time since transplant (months), and the number of co-medications represented significant differences between the nonadherents and adherents (49.80 ± [10.592] vs 36.22 ± [11.434] P < 0.05), (9.80 ± [5.263] vs 4.27 ± [2.910] P < 0.05) ( 9(5.4%) vs 157 [94.6%] P < 0.05), respectively. Conclusion: The adherence level of the studied participants was high. The nonadherence level was strongly associated with the patient’s age, time since transplants, daily dose, and number of co-medications administered.