Skip to Main Content

INTRODUCTION

“…any organ that is rejected because of noncompliance is an organ that could have been given to someone else who may have died on the waiting list.”

–Laederach-Hofmann et al. (2000)

DEFINITION

  • Degree to which the person’s behavior does not correspond with the agreed recommendation from the health care provider.

FORMS AND FEATURES OF NONCOMPLIANCE

  • Clinical noncompliance

    • Clinically measurable events (e.g., rejection episodes, organ loss or death)

  • Subclinical noncompliance

    • Noncompliant patient who has not experienced a clinical adverse event yet

COURSE OF COMPLIANCE

  • Compliance declines over the course of time.

RISK FACTORS FOR NONCOMPLIANT BEHAVIOR

See Table 31-1 for a list of risk factors that can lead to noncompliant behavior.

TABLE 31-1Risk Factors

AREAS OF POSTOPERATIVE NONCOMPLIANCE

Medication Noncompliance

  • Major cause of late acute rejection

  • Approximately 30.8% of patients were noncompliant with immunosuppressive therapy.

    • Fifteen percent to 25% in adult transplant recipients

    • Approximately 50% in adolescent transplant recipients

    • Reported 15.7% in pediatric transplant recipients

  • Young and from a lower socioeconomic group are more likely to be noncompliant

  • Measurement of medical compliance (Table 31-2)

  • Measurement of noncompliance variables (Table 31-3)

“…even the most clever immunosuppressive regime is ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.