Noncompliance with therapy is one possible explanation for the observation that long-term graft survival is not sufficiently improved by the development in immunosuppression. The aim of the study was to explore the prevalence, characteristics and risk factors of noncompliance with immunosuppression. A total of 161 adult kidney transplant recipients were interviewed about their self-rated health, social support, education, stress from adverse effects and compliance with the immunosuppression. The prevalence of subclinical noncompliance was 54%. Noncompliant patients declared significantly worse self-rated health, less satisfaction with social support and higher stress from adverse effects. Male gender (OR 7.5, CI 2.4-23.39), high stress from adverse effects (OR 12.27, CI 2.44-61.88), fair self-rated health (OR 4.45, CI 1.04-19.55) and fair satisfaction with social support (OR 4.55, CI 1.08-19.24) were predictors of noncompliance. Standardized detection methods should be developed with the aim of identifying patients who are at risk of noncompliance in order to prevent graft loss.

Objectives This systematic review focuses on the role of the intensity of fear in patient’s delay in cancer and in myocardial infarction. Methods In a search of literature published between 1990 and June 2009, 161 articles were found. After the use of inclusion and exclusion criteria, 11 articles in cancer and 4 articles in myocardial infarction remained. Results High levels of fear are associated with earlier help-seeking in both diseases; for low levels of fear, the picture is unclear. Conclusion The level of fear is an important factor, which should be taken into account when facilitating help-seeking by patients.