To investigate the current status of drug compliance of immunosuppressant and analyze its influencing factors in kidney transplant recipients during the COVID-19 pandemic.

540 renal transplant recipients who were followed up in the outpatient clinic in the Organ Transplantation Center of the Second Affiliated Hospital of Guangzhou Medical University, from June 2021 to December 2021, were selected by the convenience sampling method to do the questionnaire. Surveys on general information, COVID-19 and COVID-19 vaccine, and drug compliance of immunosuppressant were conducted in renal transplant recipients. All the questionnaires were promptly organized and analyzed after collection, and then the invalid questionnaires were excluded. The recipients were divided into high drug compliance group and low drug compliance group according to drug compliance of immunoswppressant. The measurement data of normal distribution between groups were compared by group t test. Chi-squared test was used to compare the counting data. P<0.05 indicates a statistically significant difference.

A total of 540 survey questionnaires were distributed in this study, with 29 invalid questionnaires excluded. A total of 511 valid questionnaires were collected, with a recovery effectiveness rate of 94.6% (511/540). Among 511 recipients, 403 recipients (78.9%) expressed concern about the COVID-19 pandemic, but 450 recipients (88.1%) stated that they would not experience COVID-19. Only 5 (1.0%) recipients had experienced COVID-19. 260 (50.9%) recipients were willing to receive COVID-19 vaccine, and 486 recipients (95.1%) would choose to receive inactivated vaccine, 414 recipients (81.0%) were most concerned about acute rejection for vaccination. For 511 recipients in the past month, 203 recipients (39.7%) forgot to take immunosuppressive medication once or more; 16 recipients (3.1%) forgot to take immunosuppressive medication twice or multiple times; 213 recipients (41.7%) received immunosuppressive medication early or delayed for 2 hours; 12 recipients (2.3%) adjusted the dosage of immunosuppressive medication on their own. 225 recipients (44.0%) forgot or stopped taking the anti-rejection drugs due to personal factors. 87 recipients (17.0%) reported taking medication incorrectly due to busy work schedules. Only 8 recipients (1.6%) were unable to go out to purchase medication due to the COVID-19 pandemic. Among 511 recipients, 247 recipients were included in high drug compliance group and 264 recipients were included in low drug compliance group. There were significant differences between the two groups in terms of educational level and serum creatinine level for recent time (χ²=117.12, t=-6.48, all P<0.05).

The drug compliance of kidney transplant recipients remains to be improved, and the education status may be related to the drug compliance of immunosuppressant of kidney transplant recipients. Corresponding intervention measures should be taken to improve the drug compliance.