Predicting Medication Adherence and Employment Status Following Kidney Transplant: The Relative Utility of Traditional and Everyday Cognitive Approaches

Objective: The authors investigated the utility of both traditional and everyday cognitive measures in predicting medication adherence and employment status among kidney transplant recipients. In addition, the role of noncognitive predictors was examined.

Method: Cognitive measures of processing speed, memory, everyday problem solving, executive functioning, and questionnaires assessing mood, medication adherence, and employment status were individually administered to 108 kidney transplant recipients. Because the eligibility criteria differed for the two analyses, there were 103 participants in the medication adherence analyses and 94 participants in the employment analyses. Stepwise hierarchical regression and sequential binomial logistic regression analyses were conducted for continuous and dichotomous outcome measures, respectively.

Results: Findings indicate that both poorer performance on the everyday problem-solving test and a higher number of depressive symptoms were predictive of poorer self-reported medication adherence (R(2) = .19, p < .01). Furthermore, being on antidepressant medication, having a higher number of depressive symptoms, and poorer performance on traditional neuropsychological measures were predictive of fewer hours worked (Nagelkerke's R(2) = .29, ps <.05).

Conclusions: This study highlights the differential associations between neurocognitive and psychosocial status, and medication adherence and employment status following kidney transplantation. The findings suggest that the relative importance of traditional and everyday measures is dependent upon the outcome examined.