. Author manuscript; available in PMC: 2022 Dec 1.

Published in final edited form as: Transplant Rev (Orlando). 2021 Sep 20;35(4):100651. doi: 10.1016/j.trre.2021.100651

Table 1:

Design of all included studies

Author/Year	Population	Study design	Measure of adherence	Duration	Number of HTx participants	Participant Age (SD)	Attrition rate
Blanca Martinez Perez (2013)¹⁴	Pts who received transplant between 2001 and 2011, seen at a large hospital complex in Spain	Cross-sectional study	Morisky-Green test and immunosuppressant drug levels	N/A	99	50 (12) years old	N/A
Brocks (2017)¹⁵	Pts at least 18 years old, associated with a German heart transplant clinic who could speak German (survey conducted by mail)	Cross-sectional study	ITAS measure	4 months	505	Range: 18 to 90 years.	N/A
De Geest (1998)²⁵	Adult patients taking cyclosporine as part of their regimen from academic centers in Leuven, Belgium.	Prospective cohort trial	Electronic pill bottle monitor	3 months	101	Median 56.0 (range 20.0–69.0)	1/101
De Geest (2014)¹⁶	Questionnaires completed by pts who are part of the Swiss Transplant Cohort Study; pts were evaluated and waitlisted for transplantation in Switzerland	Prospective cohort study	Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS)	3 years	126	Age of all solid-organ transplant patients was 52.5 (13.1)	32/126
Denhaerynck (2018)³²	Pts recruited through the Building Research Initiative Group: Chronic Illness Management and Adherence in Transplantation (BRIGHT) study, which used multistaged sampling to examine 36 HTx centers in Europe, North America, South America, and Australia.	Cross-sectional study	Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS)	Not stated	1397	53.6 (13.2)	N/A
Dobbels (2004)¹⁷	Patients recruited at outpatient clinic visits at the Leuven Heart Transplant Program, Belgium	Prospective cohort study	Medication Event Monitoring System (MEMS)	5 years	101	55 (10)	0/101
Doesch (2013)¹⁸	Patients were recruited from the Department of Cardiology, Heidelberg University Hospital, Germany. Patients had to be at least 6 months post-HTx and free from acute infection or rejection for 4 months prior to study inclusion. Patients also had to be on stable doses of conventional TAC or CsA for 4 months preceding study entry (as part of a dual immunosuppressive regimen).	Prospective cohort study	Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS)	8 months	76	46.0 (14.4)	4/76
Doesch (2010)¹⁹	Patients were recruited from the Department of Cardiology, Heidelberg University Hospital, Germany. Patients had to be at least 6 months post-HTx and free from acute infection or rejection for 4 months prior to study inclusion. Patients also had to be on stable doses of conventional TAC or CsA for 4 months preceding study entry (as part of a dual immunosuppressive regimen).	Prospective cohort study	Visual Analogue Scale (VAS) and Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS)	4 months	54	46.2 (14.1)	4/54
Epstein (2014)²⁶	Data collected from Kaiser Permanente’s Heart Transplant Service in Santa Clara, CA.	Cross-sectional study	Immunosuppressant Therapy Adherence Scale (ITAS)	N/A	52	54.46 (no SD)	N/A
Farmer (2013)²⁷	4 US medical centers	Prospective cohort study	Assessment of Problems with the Transplant Regimen Scale	10 years	555	58.58 (8.93) in dead group, 59.50 (9.94)in alive group	30%
Goetzmann (2008)²⁰	German-speaking patients who had received a heart at University Hospital Zurich, Switzerland	Cross-sectional study	Transplant Effects Questionnaire translated into German (TxEQ-D)	N/A	41	At follow up: mean 62.0, range (24–75)	N/A
Gomis-Pastor (2020)²¹	Adults less than 1.5 years from heart transplant recruited from cardiology outpatient clinic in Barcelona, Spain	Prospective cohort study	Simplified Medication Adherence Questionnaire (SMAQ)	mean 2.3 mos (SD 0.9)	31	54 (12)	0/31
Grady (2016)²⁸	Adults transplanted 5–10 years prior at 4 US medical centers	Cross-sectional study	Assessment of Problems with the Heart Transplant Regimen	N/A	210	Age of recipient at transplant: women: 48.8 (12.0), men: 57.1 (8.5)	N/A
Grady (1998)²⁹	Adults transplanted 1–2 years ago from two US academic medical centers	Prospective cohort study	Assessment of Problems with Heart Transplant Regimen	2 years	120	None given	44/120
Grady (1999)³⁰	Adults transplanted 1 year ago at two US academic medical centers	Cross-sectional study	Assessment of Compliance with Transplant Regimen	N/A	232	53.9 (9.3)	N/A
Helmy (2019)³³	Pts recruited through the Building Research Initiative Group: Chronic Illness Management and Adherence in Transplantation (BRIGHT) study, which used multistaged sampling to examine 36 HTx centers in Europe, North America, South America, and Australia. Pts transplanted 1–5 years ago.	Cross-sectional study	Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS)	N/A	1397	53.7 (13.2)	N/A
Hugon (2014)²²	French-speaking adult patients who had received a solid organ transplant at least 3 months ago. Questionnaire sent by mail.	Cross-sectional study	Scale based on Morisky-Green; IS trough levels also collected. nonadherent if the self-reported adherence score was ≤ 4 (3) and/or had a ratio of inadequate trough concentrations >0.2.	N/A	43	Age of all solid-organ transplant patients was 55.7 (13.0)	N/A
Kung (2012)³⁴	English speaking patients who received transplants at least 3 months prior at one of two solid organ transplant centers in New Zealand.	Cross-sectional study	Immunosuppressant Therapy Adherence Scale (ITAS) based on scoring 12 or less, where a score of 12 indicates perfect adherence	N/A	87	54.4 (11.8)	N/A
Milaniak (2014)²³	Adults transplanted at least 3 months ago at a transplant and surgery department in Poland	Cross-sectional study	Transplant Effects Questionnaire (TxEQ) - Subscale scores are expressed as a mean obtained by dividing the total score by the number of items ranging from 1 to 5. Tertiles were used to estimate the emotional response, so that a score of 1–2.3 represents a low emotional response, 2.4–3.6 a moderate response and 3.7–5 a high level of emotional response.	N/A	46	52.36 (13.55)	N/A
Scholz (2012)⁵³	Adults transplanted with a solid organ (heart, liver, kidney, lung) at least 6 months ago at University Hospital Zurich, Switzerland	Cross-sectional study	Five-item adherence subscale of the German version of the Transplant Effects Questionnaire (TxEQ-D)	N/A	19	Age of all solid-organ transplant patients was 54.32 (13.32)	N/A
Shamaskin (2012)³¹	Pts at least 21 years old and 5 years post heart transplant recruited from one of 4 US medical centers	Cross-sectional study	Assessment of Problems with Heart Transplant Regimen	N/A	555	Age in three groups: younger: 42.2 (7.1), middle aged: 59.1 (4.2), older: 69.4 (2.8)	N/A
Shemesh (2017)³⁶	Hebrew-speaking patients cared for at an tertiary medical center outpatient clinic in Israel.	Cross-sectional study	Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS) - overall nonadherence defined as that is, missing one or skipping two or more doses, not maintaining a timing of medication intake, altering the prescribed amount, or completely stopping intake of IS medications	N/A	102	56.66 (15.38)	N/A
Vitinius (2019)²⁴	German-speaking patients who were inpatients or outpatients followed at the University of Cologne, Germany; recruited before transplant.	Prospective cohort study	Medication experience scale for immunosuppressants (MESI)	Pre-transplant to 6 months post transplant	20	Average age of participants of both studies included in this manuscript: 53.5 (11.75)	9/20
Zhang (2019)³⁵	Adult patients at least 3 months from admission for heart transplant from a medical college and university in China.	Cross-sectional study	Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS)	N/A	186	51.5 (interquartile range 41.0–58.0)	18/186 did not complete instrument

HTx: Heart transplant; Pt: Patient; N/A: not applicable