Purpose:
1. To investigate the current status of immunosuppressive medication (ISM) adherence in renal transplant recipients. 
2. Based on the Health Belief Model to investigate the influence of social demographical factors, social support, ISM treatment satisfaction, knowledge of ISM, ISM taking barriers and self-efficacy on long-term ISM use on the medication adherence in renal transplant recipients.
Methods: A cross-sectional design was used in this study. Convenience sampling method was used to recruit renal transplant recipients at the follow-up clinic from a general teaching hospital. The investigation instruments included a self-designed general condition questionnaire, Perceived Social Support Scale, Treatment Satisfaction Questionnaire for Medication, Patient-perceived Medication Knowledge in Medication Use Scale, Immunosuppressant Therapy Barrier Scale, Long-term Medication Behavior Self-efficacy Scale, and Basel Assessment of Adherence with Immunosuppressive Medication Scale. IBM SPSS 23.0 was used to perform statistical analysis.
Results: Totally 233 questionnaires were handed out,195 questionnaires were valid and analyzed. Medication non-adherence rate was 47.18% in this study. Timely non-adherent was the most serious aspect, 39.49% renal transplant recipients took ISM more than two hours before or after the prescribed dosing time; 13.85% recipients had missed taking at least one dose of ISM. Moreover, eight (4.10%) recipients had altered the prescribed amount of their ISM. The multiple stepwise regression model showed that the perceived uncontrollable barriers (β=0.24, P<0.01), treatment satisfaction (side effects of medication) (β=-0.16, P<0.05), organ source (β=0.24, P<0.01), the time post transplantation (β=0.20, P<0.01) and accompanying diseases (β=0.17, P<0.01) were the main influencing factors on medication adherence in renal transplant recipients, and the above five variables could explain 21.66% of the total variance variation on ISM adherence in renal transplant recipients.
Conclusion: Renal transplant recipients are at high rate of ISM non-adherence in this study. Recipients who received living donor transplantation, had accompanying diseases, longer time after transplantation, unsatisfied with side effects of medication, and perceived uncontrollable barriers have worse ISM adherence. Integrated interventions should be developed to improve the ISM adherence in renal transplant recipients. Key Words: kidney transplantation, medication adherence, health belief model