Title : Medication adherence and associated factors among liver transplant recipients in Vietnam: A cross-sectional study using the BAASIS scale

Background: Medication non-adherence after liver transplantation remains a significant challenge and is associated with adverse clinical outcomes. However, data from Southeast Asia are limited. This study aimed to assess medication adherence and explore associated factors among liver transplant recipients using a standardized BAASIS-based assessment.

Methods: A cross-sectional study was conducted in 136 adult liver transplant recipients attending outpatient follow-up at a tertiary center in Vietnam. Medication adherence was assessed using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS). Demographic and clinical data were extracted from medical records. Associations between adherence and clinical variables were analyzed using chi-square tests and logistic regression.

Results: Overall, 70.6% of patients were classified as adherent and 29.4% as non-adherent. Timing deviations were the most common form of non-adherence (27.2%), whereas missed doses (7.4%), drug holidays (0.7%), and dose modification (1.5%) were less frequent. Non-adherence increased with time since transplantation (17.4% at ≤12 months vs 38.0% at >36 months; p for trend = 0.027). No statistically significant associations were observed between adherence and clinical outcomes, including hospital readmission, infection, acute rejection, and biliary complications.

Conclusions: Non-adherence remains common among liver transplant recipients and is predominantly characterized by timing deviations. Adherence appears to decline over time after transplantation. Structured long-term monitoring and targeted interventions are needed to improve adherence in this population.

Nguyen Thi Van Anh is a hepatobiliary nursing specialist with more than 15 years of clinical experience in liver, biliary, and pancreatic surgery. She obtained her Master’s degree from Hanoi Medical University, Vietnam. Her professional and research interests include liver transplantation, postoperative nursing care, immunosuppressive medication adherence, and patient safety in hepatobiliary surgery. Ms. Nguyen has authored and co-authored numerous scientific publications related to nursing practice and clinical care. She is actively involved in clinical nursing management, research activities, and the development of evidence-based nursing practice in Vietnam.