OBJECTIVES : Non-adherence to drug regimen in kidney transplant recipients can lead to deprived quality of life, graft rejection, increased hospital admissions, and death. The evidence on medication non-adherence in kidney transplant recipients is lacking. This study aimed to evaluate the medication non-adherence in kidney transplant recipients.

METHODS : This systematic review searched PubMed, Embase, and Cochrane library databases (from 1990 to Jun 2020). This systematic review was conducted according to guidelines from the Cochrane handbook for systematic reviews and followed the preferred reporting items for systematic reviews and meta-analyses statement guidelines. All kidney transplants recipients were included. Non-adherence was defined according to the questionnaires/scales/methods used in different studies. Search restricted to the English language.

RESULTS : A total of 11 studies met the inclusion criteria were included. Medication non-adherence was assessed using five scales/questionnaires (Basel assessment of adherence scale for immunosuppressive [BAASI]-three studies, immunosuppressive therapy adherence scale [ITAS]-three studies, Morisky medication adherence scale [MMAS]-one study, self-reported questionnaire [SRQ]-one study, and visual analog scale [VAS]-one study).

The prevalence of self-reported medication non-adherence ranged from 14.0% to 70.5%. The physician reported medication non-adherence was 9.2%. Prevalence of adherence assessed using ITAS ranged from 37.0% to 57.8%, using BASIS ranged from 34.0% to 70.5%, using MMAS ranged from 31.7% to 28.3%, and using VAS was 14.0%.

CONCLUSIONS : This systematic review demonstrated poor medication adherence in kidney transplant recipients. Further research to identify the factors to improve medication adherence could help to improve patient’s quality of life and decreasing graft rejection.