48 per cent of Hong Kong patients receiving a new organ fail to follow drug guidelines
Some just forget to take the medication, others blame busy work schedules and incompatibility with lifestyles and eating patterns, survey reveals
Sourcing organs for those in need of transplants is hard enough, but doctors face a second hurdle in making sure recipients take their drugs to keep them working properly.
Nearly half of 529 transplant recipients surveyed by the Society of Transplantation, Transplant Sports Association and Liver Transplant Patients’ Association admitted not properly taking the medicine that stops the body rejecting the new organs.
Such drugs help the immune system adjust to a transplanted heart, liver or kidney.
“Even if you’re lucky enough to receive an organ transplant, it doesn’t mean the treatment is over. Patients must continue a course of medication ... indefinitely,” said Dr William Lee, president of the Society of Transplantation.
“If a patient does not follow instructions on taking their medicine, it could lead to failure of the transplanted organ.”
Hong Kong has one of the lowest organ donation rates in the world with only 5.8 donors per one million people, compared with 39.7 in Spain.
Failure to take the correct dosage at the time instructed – two hours before a meal – could elevate the risk of future complications and rejection by about 1.4 times.
While 90 per cent understood the importance of compliance, 48 per cent said they failed to take medication on an empty stomach as instructed by their doctors. The main excuses included incompatibility with lifestyles and eating, irregular work schedules and forgetfulness. Some respondents said they feared being seen taking medication and judged by peers.
Olive Cheung, 55, who received a kidney transplant in 2008, admitted it was tough sticking to the twice-a-day pre-meal regimen with a busy work schedule and having to frequently travel overseas for business.
“At times I would get very busy with my daily chores and so would miss my medication easily,” she said. “It’s also hard to follow the two-hour-before-meal rule at night as I would take my medicine after work ... and only at 9pm could I then have something to eat.”
Dr Chak Wai-leung, the society’s immediate past president, urged doctors to step up public education, while patients could remind themselves by using electronic pill boxes, setting alarms or using mobile apps. The idea, he said, was to be responsible to themselves and their donors.
“Organ transplants are a very rare opportunity,” he said. “If their new organs are damaged, patients will have to end up in the same queue again. This affects the lives of others who have yet to receive donations.”
The survey, commissioned to the University of Hong Kong public opinion programme, was the first to look at drug compliance among transplant patients in a Chinese community.