Psychological factors associated with medication non-adherence after kidney transplant: a systematic review.
8 affiliations
- 1Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. [email protected].
- 2Department of Psychological Medicine, National University Hospital, Singapore, Singapore. [email protected].
- 3Department of Psychological Medicine, National University Hospital, Singapore, Singapore.
- 4Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
- 5Institute of Health and Wellbeing, Federation University Australia, Victoria, Australia.
- 6Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- 7National University Centre for Organ Transplantation, National University Hospital, Singapore, Singapore.
- 8Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore.
Abstract
Medication non-adherence remains a persistent and critical challenge among kidney transplant recipients, who demonstrate higher rates of non-adherence than other solid organ transplant populations. Given the associated risks of graft rejection, graft loss, and mortality, a clearer synthesis of underlying psychological factors is needed. This systematic review synthesized evidence on psychological factors associated with self-reported medication non-adherence among adult kidney transplant recipients, integrating quantitative and qualitative research to capture patients' perspectives. Following Joanna Briggs Institute guidelines, five electronic databases (Embase, PubMed, PsycINFO, Scopus, and Web of Science) were searched from inception to 5 May 2026. Eligible studies included quantitative and qualitative research involving adult recipients. Methodological quality was appraised using the Mixed Methods Appraisal Tool, and findings were integrated using a convergent integrated approach. Forty-four studies comprising 11,180 participants were included. Non-adherence prevalence ranged from 12.0% to 89.2%. Four overarching themes were identified: psychological distress, perceptions and beliefs, coping strategies, and social-contextual factors. Depressive symptoms and low social support were the most consistent correlates. Qualitative findings highlighted emotional burden, stigma, and regimen complexity as additional barriers. Medication non-adherence is multifactorial and context dependent. Integrating psychosocial screening and patient-reported outcomes into routine transplant care may improve adherence and long-term graft outcomes.
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BibTeX
@article{neo2026psychological,
title = {{Psychological factors associated with medication non-adherence after kidney transplant: a systematic review.}},
author = {Hui Ling Michelle Neo and Kuhanesan N C Naidu and Isabella Jia Hui Tang and Ho Yee Tiong and Shawn Yong Shian Goh and Cyrus Su Hui Ho},
journal = {BMC psychology},
year = {2026},
month = jul,
doi = {10.1186/s40359-026-05233-7},
url = {https://europepmc.org/article/MED/42907905},
note = {CC BY},
}
RIS
TY - JOUR
TI - Psychological factors associated with medication non-adherence after kidney transplant: a systematic review.
AU - Hui Ling Michelle Neo
AU - Kuhanesan N C Naidu
AU - Isabella Jia Hui Tang
AU - Ho Yee Tiong
AU - Shawn Yong Shian Goh
AU - Cyrus Su Hui Ho
PY - 2026
DA - 2026/07/27
JO - BMC psychology
DO - 10.1186/s40359-026-05233-7
UR - https://europepmc.org/article/MED/42907905
AB - Medication non-adherence remains a persistent and critical challenge among kidney transplant recipients, who demonstrate higher rates of non-adherence than other solid organ transplant populations. Given the associated risks of graft rejection, graft loss, and mortality, a clearer synthesis of underlying psychological factors is needed. This systematic review synthesized evidence on psychological factors associated with self-reported medication non-adherence among adult kidney transplant recipients, integrating quantitative and qualitative research to capture patients' perspectives. Following Joanna Briggs Institute guidelines, five electronic databases (Embase, PubMed, PsycINFO, Scopus, and Web of Science) were searched from inception to 5 May 2026. Eligible studies included quantitative and qualitative research involving adult recipients. Methodological quality was appraised using the Mixed Methods Appraisal Tool, and findings were integrated using a convergent integrated approach. Forty-four studies comprising 11,180 participants were included. Non-adherence prevalence ranged from 12.0% to 89.2%. Four overarching themes were identified: psychological distress, perceptions and beliefs, coping strategies, and social-contextual factors. Depressive symptoms and low social support were the most consistent correlates. Qualitative findings highlighted emotional burden, stigma, and regimen complexity as additional barriers. Medication non-adherence is multifactorial and context dependent. Integrating psychosocial screening and patient-reported outcomes into routine transplant care may improve adherence and long-term graft outcomes.
SN - 2050-7283
ER -