"Social factors such as relationship with health care practitioners, social support from family, friends, and colleagues as well as demands made by these individuals are all likely to impact lifestyle and medication adherence. Being unmarried or living alone for example has been found to be a risk factor for nonadherence. Unique salient for kidney and liver transplant recipients is the relationship with a living donor, which may affect transplant outcomes such as adherence.
Therapy-related factors include perceived and experienced side effects of medication. Patients who fear greater side effects are likely to be less adherent. Therapy-related factors may facilitate or hinder adherence, such as complexity of the regime (e.g. number and timing of medications), fitting medication into a busy lifestyle, and use of tools such as a pillbox.
It is also likely that the extent to which the patient has been involved in the decision-making surrounding the regime and their wishes have been taken into account will determine the level of adherence. Patients are perhaps more likely to be prepared for the rigours of the medication regime and other behavioural requirements after transplantation if the health care provider incorporates discussion of these things during the recepient work-up. Furthermore, the attitude and beliefs of the health care provider regarding the regime and the patient are likely to influence adherence. Health care providers may be more inclined to address adherence-issues if they are afforded the time and resources to do so.
Finally, structural programmes and resources on offer from the health care provider, and cooperation of the employer and other system-related factors may facilitate or hinder adherence to the new regime required after transplantation", Emma Massey reports.