The application of the necessity-concerns framework in investigating adherence and beliefs about immunosuppressive medication among Chinese liver transplant recipients

Abstract Objective This study aimed to explore adherence to and beliefs about immunosuppressive medication using the Necessity-Concerns Framework (NCF) in liver transplant recipients. Methods A cross-sectional study performed in recipients who were at least 3 months post liver transplantation. A convenience sample of 243 recipients was recruited. Self-reported medication adherence was measured by the Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS). The NCF was operationalized using the Beliefs about Medication Questionnaire (BMQ) to assess the beliefs about necessity and concerns with taking immunosuppressive medication. Results One-hundred-forty-five liver transplant recipients were non-adherent (59.67%). Compared to adherers, non-adherers had lower beliefs regarding the necessity of taking immunosuppressive medication and lower scores on the necessity-concerns different from adherers. Conclusions Non-adherence is common in liver transplant recipients. Non-adherers hold beliefs that are different from adherers. Efforts to increase adherence should be made by targeting medication beliefs.