Adherence to Immunosuppressive Medication in Iraqi Kidney Transplant Recipients During the First Year of Transplant. A Single-Center Experience.

Objectives: Our objective was to measure adherence to immunosuppressive medications among Iraqi renal transplant patients at a single center.

Materials And Methods: This cross-sectional study was conducted from January to November 2020 in the outpatient unit of the Nephrology and Renal Transplantation Center in Baghdad's Medical City. Seventy-five adult Iraqi renal transplant recipients were recruited. An Arabic version of the Basel Assessment of Adherence to Immunosuppressive Medications (BAASIS) scale was used to evaluate adherence.

Results: The study included 75 adult renal transplant recipients (51 men/24 women) with a mean age of 39.44 ± 12.06 years. The mean time posttransplant was 8.11 ± 3.12 months. In our patient group, 65.33% reported total adherence and 34.6% did not adhere to one (25.3%) or more (9.3%) drug. We observed a statistically significant association between nonadherence and complications (P = .015, chi-square test). Four patients had biopsy-proven acute rejection, and all 4 patients were noncompliant with medications. Binary logistic regression model P values for employment, time after transplant, and complications were .06, .06, and .08, respectively.

Conclusions: There was a high rate of nonadherence among our sample of Iraqi renal transplant recipients in the first year posttransplant. Time after transplant and transplant complications were related to nonadherence. More extensive multicenter studies are needed to define the actual rate of adherence to immune suppression in Iraq.