{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T16:56:33Z","timestamp":1777913793182,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:00:00Z","timestamp":1774656000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100008485","name":"Swiss Academy of Medical Sciences","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008485","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100008868","name":"International Society for Heart and Lung Transplantation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008868","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006044","name":"Astellas Pharma Europe","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006044","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009889","name":"International Transplant Nurses Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009889","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["West J Nurs Res"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Nonadherence to heart transplantation-related medications involves both immunosuppressant drugs and co-medications; yet the correlates of heart transplantation patients\u2019 overall medication nonadherence remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We aimed to (1) describe nonadherence to both immunosuppressive and co-medication among Spanish heart transplantation patients, (2) to identify individual-level predictors of co-medication nonadherence, and (3) to describe nonadherence to non-pharmacological advice (eg, sun protection, physical activity, alcohol use) and clinical practice patterns of transplant centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      For this multicenter cross-sectional study, we surveyed 224 adult patients attending 5 Spanish centers 1 to 5\u2009years post-transplantation. We assessed nonadherence to immunosuppressants and co-medications using the Basel Assessment of Adherence to Immunosuppressive Medication Scale (BAASIS\n                      <jats:sup>\u00a9<\/jats:sup>\n                      ). Correlates of nonadherence to co-medications were derived from the Integrative Model of Behavioral Prediction using self-report instruments, as were non-pharmacological treatment adherence and treatment centers\u2019 practice patterns. Supported by causal mapping, multiple logistic regression analysis allowed adjustment for relevant confounders.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Nonadherence prevalence was 16.5% for co-medications (range across centers: 7.4%-25.0%), versus 9.4% (range: 2.6%-22.2%) for immunosuppressants. Adherence support varied across centers. Barriers to immunosuppressant nonadherence predicted co-medication nonadherence (odds ratio\u2009=\u200911.80; 95% CI, 2.59-53.69). Nonadherence to non-pharmacological treatments, particularly sunscreen use (59.3%) and physical activity (31.8%), were also common.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Post-heart transplantation co-medication nonadherence surpasses immunosuppressant nonadherence. Barriers to immunosuppressant adherence strongly predict co-medication nonadherence. While no direct causal relationship is clear, immunosuppressant nonadherence may prove useful for identifying patients prone to co-medication nonadherence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/01939459261422817","type":"journal-article","created":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T12:03:18Z","timestamp":1774699398000},"page":"468-478","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Person-Level Correlates of Nonadherence to Co-Medication in Spanish Heart Transplant Recipients"],"prefix":"10.1177","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3085-167X","authenticated-orcid":false,"given":"Maria Generosa","family":"Crespo-Leiro","sequence":"first","affiliation":[{"name":"Unidad de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiolog\u00eda, Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC), Complexo Hospitalario Universitario de A Coru\u00f1a (CHUAC), SERGAS, A Coru\u00f1a, Spain"},{"name":"Universidade da Coru\u00f1a, Grupo de Investigaci\u00f3n Cardiovascular, Departamento de Ciencias de la Salud e Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC), A Coru\u00f1a, Spain"},{"name":"Centro de Investigaci\u00f3n Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa Rosal\u00eda","family":"P\u00e9rez-Castro","sequence":"additional","affiliation":[{"name":"Universidade da Coru\u00f1a, Grupo de Investigaci\u00f3n Cardiovascular, Departamento de Ciencias de la Salud e Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC), A Coru\u00f1a, 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