Table 5:

Studies exploring health outcomes associated with adherence and nonadherence

Author (year)	Measure of adherence	Outcome variable	Association with preceding adherence/nonadherence
Dobbels (2004)17	Medication Event Monitoring System (MEMS)	Transplant coronary artery disease (CAD), defined as any degree of angiographically detectable CAD on routine annual coronary angiogram	Significantly associated with nonadherence: (OR 1.779; 95% CI: 1.20 – 2.64; p = 0.025)
		Late acute rejection defined as biopsy-proven Grade >1B rejection	Trend toward nonadherence but not significant: (OR 4.941; 95% CI: 0.75 – 32.69; p = 0.131)
		Retransplant as noted in the medical record	Trend toward nonadherence but not significant: (OR 5.4; 95% CI: 0.82 – 35.42; p = 0.114)
		5-year mortality as noted in the medical record	Not significant (OR 1.098; 95% CI: 0.26 – 4.64; p = 0.999)
		Clinical-event-free time without the above 4 events	Significantly associated with adherence: (mean 1612 days vs. 1318 days; p = 0.043)
		Adjusted relative risk of clinical event per Cox regression analysis	After controlling for other known transplant-related risk factors for poor clinical outcome, trend toward nonadherence but not significant: ARR = 2.03; p = 0.0582
Farmer (2013)27	Assessment of Problems with the Transplant Regimen Scale	Death at 5–10 years as observed in the medical record	High compliance significantly inversely associated with death: (HR 0.26; 95% CI: 0.08–0.81; p=0.02) Moderate compliance significantly inversely associated with death: (HR 0.34; 95% CI: 0.14–0.79; p=0.01)
De Geest (1998)25	Electronic pill bottle monitor	Acute late rejection during the course of the study	Significantly associated with noncompliance: rate 1.2% in excellent compliers, 14.3% in minor subclinical noncompliers and 22.2% in moderate subclinical noncompliers; p = 0.01

OR: odds ratio; CI: Confidence interval; HR: Hazard ratio