Date of Graduation


Document Type


Degree Name

Bachelor of Science in Nursing

Degree Level





Ballentine, Hope

Committee Member/Reader

Zayas, Fernanda



Kidneys are the most commonly transplanted organ in the United States. All patients who receive a renal transplant must be on lifelong immunosuppressants to prevent rejection of the donor organ. The majority of patients do not take their immunosuppressant medications as instructed, making noncompliance a huge issue for medical professionals. The purpose of this literature review is to explore what evidence-based techniques nurses should employ to increase the long-term compliance of immunosuppressants in renal transplant patients. A literature review was performed of fifteen studies to identify interventions that nurses can employ to increase immunosuppressant compliance. CINAL and Medline were searched using Boolean phrases, and studies were sorted using search limiters and inclusion and exclusion criteria. All studies included in this literature review are peer-reviewed academic journals.

Nurses can assess motivating factors and barriers to learning prior to teaching renal transplant patients about immunosuppressant therapy using evidence-based tools and questionaries. While teaching, nurses should promote self-advocacy and accountability to prevent both intentional and unintentional non-compliance to long-term immunosuppressant medications. Increased compliance can be achieved with the use of mHealth applications and the SystemsCHANGE approach. Intentional non-compliance can be reduced with thorough teaching of correct medication use, side effects, and results of noncompliance. Nurses can use individualized assessments, tools, and technology to increase immunosuppressant compliance and decrease long term complications associated with noncompliance. Future research regarding compliance with immunosuppressants is needed to provide nurses with evidence-based interventions, and quantitative longitudinal studies could provide insight to the effects of interventions long term.


immunosuppressants, renal transplant, kidney transplant, compliance, noncompliance