{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T12:08:09Z","timestamp":1783944489206,"version":"3.55.0"},"reference-count":42,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T00:00:00Z","timestamp":1755820800000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immunosuppressive medication (IM) adherence, a dynamic and time\u2010dependent behavior, is typically suboptimal among kidney transplant recipients (KTRs) and severely impacts their prognosis. Longitudinal data regarding the temporal trajectories of medication adherence are important for devising targeted intervention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify the trajectories of IM adherence in KTRs over the 2\u00a0years post transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two hundred and twenty\u2010two KTRs were recruited from a tertiary care hospital in China between May 2020 and February 2022. Data were collected at 3\u2010, 6\u2010, 12\u2010, and 24\u2010month post kidney transplantation. IM adherence was defined according to the BAASIS scale. A group\u2010based trajectory model was used to depict and identify distinct trajectories. Univariate analysis and multinomial logistic regression were conducted to evaluate the association between baseline factors and membership in different trajectory groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of medication non\u2010adherence at 3, 6, 12, and 24\u00a0months after transplantation was 10.8%, 9.9%, 11.7%, and 22.1%, respectively. Three adherence trajectories were identified, including the \u201cconsistent adherence\u201d (65.5%), \u201chigh start and decreasing adherence\u201d (28.0%), and \u201cincreasing adherence\u201d (6.6%) trajectory group. The critical transition point, as the 6\u2010month time point after transplantation, in adherence dynamics was identified. Recipients experiencing decreasing adherence trajectories were possibly younger, received a technical\/high school education, and lived alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Distinct trajectories of medication adherence among KTRs were identified during the 2\u2010year post\u2010transplantation period. A previously unrecognized adherence trajectory\u2010the \u201cincreasing adherence\u201d trajectory and the critical transition point in adherence dynamics was identified, particularly highlighting the 6\u2010month post transplantation period as a pivotal intervention window.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70280","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T14:40:36Z","timestamp":1755873636000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trajectories of Immunosuppressive Medication Adherence Among Kidney Transplant Recipients: A 2\u2010Year Prospective Cohort Study"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9752-8810","authenticated-orcid":false,"given":"Lei","family":"Dong","sequence":"first","affiliation":[{"name":"School of Traditional Chinese Medicine Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keke","family":"Lin","sequence":"additional","affiliation":[{"name":"School of Nursing Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Liu","sequence":"additional","affiliation":[{"name":"College of Nursing and Public Health Adelphi University  Garden City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongxia","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Nursing Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Liu","sequence":"additional","affiliation":[{"name":"Health Management Medicine Center The Third Xiangya Hospital, Central South University  Changsha Hunan China"},{"name":"Nursing Department The Third Xiangya Hospital, Central South University  Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2019.100511"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/nep.13214"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2024.100900"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjms.2016.01.010"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/0886022X.2023.2238832"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20105151(03)00091\u20104"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.865"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2019.08.002"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2013.07.006"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12484"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/tri.12312"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.11817\/j.issn.1672\u20107347.2022.210666"},{"key":"e_1_2_11_14_1","unstructured":"(2008).Scientific Registry Of Kidney Transplantation https:\/\/www.csrkt.org.cn\/door\/index."},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0000000000001564"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010clinpsy\u2010081122\u2010012416"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2023.101510"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12888"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2024.105445"},{"key":"e_1_2_11_20_1","first-page":"302","article-title":"Use and Misuse of Repeated Measures Designs","volume":"142","author":"Barcikowski R. 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