Background <p>The proper use of immunosuppressants is critical for the long-term survival of kidney transplant recipients. Therefore, it is necessary to study strategies to promote the management of immunosuppressant medication adherence in adult kidney transplant patients.</p> Objective <p>This project aims to improve the immunosuppressant medication adherence management system in adult kidney transplant recipients by implementing evidence-based best practices.</p> Methods <p>This evidence-based implementation project was conducted in a kidney transplant center in China. It included a baseline audit, two implementation rounds, and two follow-up audits. In the preliminary phase, the research team had summarized 38 pieces of best evidence on immunosuppressant medication adherence management. For the clinical application phase, a multidisciplinary expert panel prioritized 18 recommendations and translated them into 23 measurable evidence-based audit criteria, including structural, process, and outcome criteria. Audits were conducted at baseline and after two implementation rounds. The healthcare personnel samples were 71 at baseline, 70 in the first follow-up audit, and 69–80 in the second follow-up audit. Patient-level audit samples varied by criterion, ranging from 35 to 82 at baseline, 30–71 in the first follow-up audit, and 31–80 in the second follow-up audit. Barriers and facilitators were systematically analyzed to develop and refine implementation strategies across both rounds.</p> Results <p>Barrier analysis informed the development and refinement of targeted implementation strategies across both rounds. At baseline, 15 of the 23 audit criteria had compliance rates below 60%. After the first round of implementation, only 6 criteria had a compliance rate below 90%. After the second round, all 23 criteria achieved a compliance rate of 90% or higher. From a system perspective, a multidisciplinary team (MDT) for managing immunosuppressant medication adherence was established and improved. The management system, specific processes, and evaluation standards were revised, and 7 information system improvement projects were completed.</p> Conclusion <p>The evidence-based implementation project for managing immunosuppressant medication adherence in kidney transplant patients, based on best evidence, was successfully carried out. However, the clinical outcomes and sustainability of the audit criteria have yet to be evaluated, which requires further research.</p>