Social support and immunosuppressant therapy adherence among adult renal transplant recipients Immunosuppressant therapy (IST) non-adherence is a serious health concern among renal trans- plant recipients (RTRs). Although IST adherence is critical to graft maintenance and survival, a recent meta-analysis revealed an IST non- adherence rate of 36% among renal transplant recipients (1). The potential consequences of non- adherence include graft failure, return to dialysis, retransplantation, and death. Approximately 35% of renal graft loss is due to IST non- adherence, and the odds of graft failure increase seven-fold in non-adherent RTRs compared with adherent RTRs (2, 3). Moreover, life expectancy for non-adherent RTRs is four yr less than that of adherent RTRs (4). According to Butler et al., potentially modifiable risk factors are primary targets for intervention strategies to promote IST adherence among RTRs (5); however, few studies address such factors and strategies that may improve IST adherence. To design and implement effective interventions and thus improve health outcomes, it is necessary to first develop a better understanding of modifiable risk factors and their associations with medication non-adherence. One such potentially modifiable risk factor is poor social support (support group Chisholm-Burns MA, Spivey CA, Wilks SE. Social support and immunosuppressant therapy adherence among adult renal transplant recipients. Clin Transplant 2009 DOI: 10.1111/j.1399-0012.2009.01060.x ª 2009 John Wiley & Sons A/S. Abstract: Background: The purpose of the study was to assess the rela- tionship between social support and immunosuppressant therapy adherence among adult renal transplant recipients. Methods: A cross-sectional, survey design was employed. Mailed ques- tionnaires were used to collect data from 81 recipients, and included the Immunosuppressant Therapy Adherence Scale ª (ITAS ª ) and Modified Social Support Survey (MSSS-5). The correlation between ITAS ª and MSSS-5 summary scores was assessed using the correlation coefficient (r). Analyses of the following relationships were conducted using correlation coefficients: (i) ITAS ª summary score and individual items of the MSSS-5; and (ii) MSSS-5 summary score and individual items of the ITAS ª . A hierarchical regression was conducted. Results: The response rate was 74%. The relationship between social support and adherence was significant (r = 0.214, p < 0.05). Two MSSS-5 items (affectionate support and instrumental support pertaining to house- hold functions) were related to ITAS ª summary score (p < 0.05), and one ITAS ª item (forgetfulness) was related to the MSSS-5 summary score (p < 0.05). The regression model (all MSSS-5 items) accounted for 24% of the variation in ITAS ª summary scores. Conclusions: The findings suggest that strategies utilizing social support to address forgetfulness as well as strategies to improve affectionate support and instrumental support related to daily household functions may be useful adherence intervention tools. Marie A. Chisholm-Burns a , Christina A. Spivey b and Scott E. Wilks c a Department of Pharmacy Practice and Science, The University of Arizona College of Pharmacy, Tucson, AZ and Department of Medicine, Medical College of Georgia, GA, USA, b Department of Pharmacy Practice and Science, The University of Arizona College of Pharmacy, Tucson, AZ, USA and c Louisiana State University School of Social Work, LA, USA Key words: immunosuppressant therapy – medication adherence – renal transplant recipients – social support Corresponding author: Marie A. Chisholm-Burns, PharmD, MPH, FCCP, FASHP, The University of Arizona College of Pharmacy, 1295 N. Martin Avenue, P.O. Box 210202, Tucson, AZ 85721, USA. Tel.: 520 626 2298; fax: 520 626 7355; e-mail: chisholm@pharmacy.arizona.edu Accepted for publication 9 July 2009 Clin Transplant 2009 DOI: 10.1111/j.1399-0012.2009.01060.x ª 2009 John Wiley & Sons A/S. 1