Adherence to treatment in patients undergoing dialysis
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20191595Keywords:
Adherence, End stage renal disease, HaemodialysisAbstract
Background: Chronic Kidney Disease (CKD) is a silent disease that is frequently diagnosed in advanced stages. The prevalence and incidence of chronic kidney disease (end-stage renal disease) are continuously increasing, particularly in elderly patients. Poor adherence to complex multimodal therapies is a widely recognized problem in the daily care of dialysis patients, contributing to excess morbidity and mortality of this population. Aims and objectives was to assess the adherence to medications among patients undergoing haemodialysis and to explore the factors affecting non adherence.
Methods: After obtaining approval from Institutional Ethics Committee, a prospective observational study was carried out among 150 patients, who were on dialysis in a tertiary care hospital, Hassan. An eight item Morisky Medication adherence questionnaire was used to assess medication adherence. Chi-square test applied to assess statistics.
Results: Adherence levels were 28%, 42% and 30% for high, medium and poor adherence respectively. The overall prevalence of non-adherence among respondents was 30%. Among them 77.77% were males, 44.44% belonged to age group of 41-60 years, 40% illiterate, 60% employed, 51.11% of patients with smoking and alcoholic habits were not adherent to Dialysis. Other reasons contributing to non-adherence to treatment were forget fullness (86.66%), inadequate knowledge about side effects (80%), unhappy clinical visits (71.11%) and lack of assistance (48.88%).
Conclusions: In this study patient showed moderate adherence. This emphasizes the need for constant motivation and education at frequent intervals to ensure better adherence.
References
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl. 2013;3:1-150.
Agarwal R. Defining end-stage renal disease in clinical trials: a framework for adjudication. Nephrology Dialysis Transplantation. 2015 Aug 11;31(6):864-7.
Schmid H, Hartmann B, Schiffl H. Adherence to prescribed oral medication in adult patients undergoing chronic hemodialysis: a critical review of the literature. Euro J Med Resea. 2009 Dec;14(5):185.
Yusop NB, Mun CY, Shariff ZM, Huat CB. Factors associated with quality of life among hemodialysis patients in Malaysia. PLoS One. 2013 Dec 16;8(12):e84152.
Al-Khattabi GH. Prevalence of treatment adherence among attendance at hemodialysis in Makah. Int J Med Sci Public Health. 2014 May 1;3(5):592-8.
Yang F, Khin LW, Lau T, Chua HR, Vathsala A, Lee E, et al. Hemodialysis versus peritoneal dialysis: a comparison of survival outcomes in South-East Asian patients with end-stage renal disease. PloS one. 2015 Oct 7;10(10):e0140195.
Safdar N, Baakza H, Kumar H, Naqvi SA. Non-compliance to diet and fluid restrictions in haemodialysis patients. J Pak Med Assoc. 1995;45(11):293-5.
Christensen AJ, Moran PJ, Wiebe JS, Ehlers SL, Lawton WJ. Effect of a behavioral self-regulation intervention on patient adherence in hemodialysis. Health Psychol. 2002;21(4):393-7.
WHO, 2003. Adherence to Long - Term Therapies: World Health Organization; 2003:3. Available at: https://apps.who.int/iris/bitstream/handle/10665/42682/9241545992.pdf
Allen D, Wainwright M, Hutchinson T. ‘Non-compliance’as illness management: Hemodialysis patients’ descriptions of adversarial patient–clinician interactions. Soci Scie Med. 2011 Jul 1;73(1):129-34.
Mersal FA, El-Sedawy DS, Mersal NA. Effect of nursing guideline on dietary and fluid compliance among patients undergoing hemodialysis. Journal of Health, Medicine and Nursing ISSN 2422-8419 An Int Peer-reviewed J. 2016;26.
Duong CM, Olszyna DP, Nguyen PD, McLaws ML. Challenges of hemodialysis in Vietnam: experience from the first standardized district dialysis unit in Ho Chi Minh City. BMC Nephrol. 2015 Dec;16(1):122.
Leggat JE, Orzol SM, Hulbert-Shearon TE, Golper TA, Jones CA, Held PJ, et al. Noncompliance in hemodialysis: predictors and survival analysis. Ame J Kidn Diseas. 1998 Jul 1;32(1):139-45.
Morisky DE, Ang A, Krousel‐Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hyperten. 2008 May;10(5):348-54.
Jin J, Sklar GE, Oh VM, Li SC. Factors affecting therapeutic compliance: A review from the patient’s perspective. Therapeutics and clinical risk management. 2008 Feb;4(1):269.
Alkatheri AM, Alyousif SM, Alshabanah N, Albekairy AM, Alharbi S, Alhejaili FF, et al. Medication adherence among adult patients on hemodialysis. Saudi J Kid Disea Transplanta. 2014 Jul 1;25(4):762.
Naalweh KS, Barakat MA, Sweileh MW, Al-Jabi SW, Sweileh WM, Sa’ed HZ. Treatment adherence and perception in patients on maintenance hemodialysis: a cross–sectional study from Palestine. BMC Nephrol. 2017 Dec;18(1):178.
Mukakarangwa MC, Chironda G, Bhengu B, Katende G. Adherence to Hemodialysis and Associated Factors among End Stage Renal Disease Patients at Selected Nephrology Units in Rwanda: A Descriptive Cross-Sectional Study. Nursing Research and Practice. 2018;2018.
Saran R, Bragg-Gresham JL, Rayner HC, Goodkin DA, Keen ML, Van Dijk PC, et al. Nonadherence in hemodialysis: associations with mortality, hospitalization, and practice patterns in the DOPPS. Kidney international. 2003 Jul 1;64(1):254-62.
