ArticleCanadian journal of kidney health and disease2021
Retrospective Analysis of Tacrolimus Intrapatient Variability as a Measure of Medication Adherence.
Article in Canadian journal of kidney health and disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Substance Use Patterns in Pediatric Solid Organ Transplant Candidates: Impact After Transplant.Pediatric transplantation · 2026Article
- Evaluation of medication adherence over a decade following kidney transplantation: integration of biological and self-reported data.BMC nephrology · 2026Article
- Oral medication adherence predicts cyclosporine blood level variability and graft versus host disease following pediatric allogeneic hematopoietic stem cell transplant.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2025Article
- Intrapatient tacrolimus variability is associated with medical nonadherence among pediatric kidney transplant recipients.Frontiers in transplantation · 2025Article
- Population pharmacokinetic modeling of missed mycophenolate mofetil doses: Impact on exposure and exploration of mitigation strategies.PloS one · 2025Article
- Impact of tacrolimus intra-patient variability in adverse outcomes after organ transplantation.World journal of transplantation · 2023Review
- Comparison of different methods to assess tacrolimus concentration intra-patient variability as potential marker of medication non-adherence.Frontiers in pharmacology · 2022Article
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Authors and funding
7 authors.
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Abstract
backgroundIncreased intrapatient variability (IPV) in tacrolimus levels is associated with graft rejection, de novo donor-specific antibodies, and graft loss. Medication nonadherence may be a significant contributor to high IPV.
objectiveThe objective of this study is to determine the utility of tacrolimus IPV in detecting nonadherence by examining the relationship between self-reported adherence and tacrolimus coefficient of variability (COV), a measure of IPV.
designRetrospective cohort study.
settingSt. Michael's Hospital, Toronto, Ontario. PATIENTS: All patients who were at least 1-year post-kidney transplant as of March 31, 2019, prescribed tacrolimus as an immunosuppressant and had a self-reported adherence status. Patients were excluded from the primary analysis of examining the correlation between COV and self-reported adherence if they lacked a calculatable COV. MEASUREMENTS: Self-reported adherence, COV, demographic data, transplant, and medication history.
methodsA modified Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS) administered by healthcare professionals to assess self-reported adherence was used. The COV of tacrolimus trough levels was calculated and its correlation to BAASIS response was noted. The median COV was used as a cutoff to examine the characteristics of patients deemed "high COV" and "low COV."
resultsA total of 591 patients fit the initial criteria; however, only 525 had a recent calculatable COV. Overall, 92.38% of the population were adherent by self-report. Primary analysis identified a COV of 25.2% and 29.6% in self-reported adherent and nonadherent patients, respectively, though the result was not significant ( LIMITATIONS: The limitations included modified nonvalidated BAASIS questionnaire, social desirability bias, BAASIS only administered in English, and patients with graft failure not active in clinic not being captured.
conclusionsThe COV should not be used as the sole method for determining medication adherence. However, COV may have some utility in capturing individuals who are not adherent to their blood work or patients who are having a poor response to tacrolimus and should be switched to another medication.
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