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Nephrol Dial Transplant (2000) 15: 1924-1927
© 2000 European Renal Association-European Dialysis and Transplant Association

Child–Adult Interface

Drug holiday: a challenging child–adult interface in kidney transplantation

Pierre Cochat,1, Sabina De Geest2 and Eberhard Ritz3

1 Département de Pédiatrie, Hôpital Edouard Herriot and Université Claude Bernard, Lyon, France, 2 Centre for Health Services and Nursing Research, Catholic University of Leuven, Leuven, Belgium, and 3 Sektion Nephrologie, Klinikum der Universität Heidelberg, Heidelberg, Germany

Introduction

Non-compliance is a major problem in any chronic medical condition and continues to be a challenge to the physicians. Increasing evidence shows its impact on graft function. Yet its assessment remains disheartening. The psychological motives underlying non-compliance are presumably more ‘forgetting’; as a result of weariness of treatment rather than pernicious self-destructive behaviour. Given its deleterious effect on graft outcome, non-compliance has increasingly become the focus of clinical research. Two scientific meetings have been devoted to this problem, which is both old and new (Arlington, USA, April 1998; Hof bei Salzburg, Austria, February 1999).

Psychological motives underlying non-compliance

Whether a patient accepts his chronic disease and the idea that he is responsible for his own health depends on many factors such as family history, religious and cultural backgrounds, emotional profile, age at onset and type of primary disease, presence of comorbid factors, and life events.

Some of the problems concern the patient. To a . . . [Full Text of this Article]

Assessment of drug compliance

Clinical spectrum of non-compliance

Risk factors

The fate of non-compliance

Can one improve drug compliance?

Conclusions

Notes

References


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