Evaluation of drug treatment awareness among caregivers and patients of chronic kidney disease: unexplored determinant in patient care
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20232562Keywords:
Dialysis, Adherence, Adverse effectAbstract
Background: Chronic kidney disease (CKD) patients are prescribed multiple drugs to slow disease progression and prevent complications mandating adherence to therapy. Lack of awareness about drug treatment is one of the contributors to nonadherence. Hence the study was conducted to explore the awareness of patients and caregivers towards CKD treatment.
Methods: The study was a cross sectional questionnaire-based study conducted among 300 CKD patients (150 dialysis/150 non-dialysis) and 100 caregivers (50 of dialysis / 50 of non-dialysis patients) attending nephrology OPD at a tertiary care hospital.Patient /caregiver awareness about drug treatment was assessed usinga prevalidated drug awareness questionnaire (8 items). The items were scored as correct response=2, no response=0 and incomplete response = -1, accounting the total awareness score as +20 to - 6
Results: The mean awareness score of patients / caregivers was 8.16±3.41 and 8.3±1.6 respectively. Majority (>70%) patients/ caregivers gave accurate responses for the items -specifying number of medicines, medication frequency and regular intake of drugs but awareness regarding action plan for skipped (27% patients, 11% caregivers) or missed doses (22% patients, 15% caregivers) and adverse effects (17% patients, 5% caregivers) was poor. Patients/ caregivers belonging to dialysis group had statistically better awareness then non-dialysis group.
Conclusions: Patient /caregiver awareness regarding drug treatment is less than 50% with strikingly low awareness about dose regimen, adverse effects, action plan for missed doses and co morbidities. Patient education programs to reinforce and retain this knowledge need to be implemented in CKD patients.
References
Stevens PE, Levin A. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Int Med. 2013;158(11):825-30.
Bikbov B, Purcell CA, Levey AS, Smith M, Abdoli A, Abebe M, et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709-33.
Singh AK, Farag YM, Mittal BV, Subramanian KK, Reddy SR, Acharya VN, et al. Epidemiology and risk factors of chronic kidney disease in India results from the SEEK (Screening and Early Evaluation of Kidney Disease) study. BMC Nephrol. 2013;14(1):114
Burnier M, Pruijm M, Wuerzner G, Santschi V. Drug adherence in chronic kidney diseases and dialysis. Nephrol Dial Transplant. 2014;30(1):39-44.
Bartlett Ellis RJ, Welch JL. Medication‐taking behaviours in chronic kidney disease with multiple chronic conditions: a meta‐ethnographic synthesis of qualitative studies. J Clin Nurs. 2017;26(5-6):586-98.
Schmid H, Hartmann B, Schiffl H. Adherence to prescribed oral medication in adult patients undergoing chronic hemodialysis: a critical review of the literature. Eur J Med Res. 2009;14(5):185.
Dsouza B, Prabhu RA, Unnikrishnan B, Shetty A, Reshmi B. A qualitative study on factors affecting adherence among indian haemodialysis patients at a tertiary teaching hospital of southern India. J Health Manag. 2019;21(3):417-26.
Sontakke S, Budania R, Bajait C, Jaiswal K, Pimpalkhute S. Evaluation of adherence to therapy in patients of chronic kidney disease. Indian J Pharmacol. 2015;47(6):668.
Plantinga LC, Tuot DS, Powe NR. Awareness of chronic kidney disease among patients and providers. Adv Chron Kidney Dis. 2010;17(3):225-36.
Guidelines. Available at: https://icmr.nic.in/sites/ default/files/guidelines/ICMR_Ethical_Guidelines_2017.pdf. Accessed on 20 February 2023.
Kidney disease. Available at: https://www.icmr.nic.in/ sites/default/files/guidelines/ethical_guidelines_0.pdf. Accessed on 20 February 2023.
Law Relatings to Drugs & Cosmetics. Available at: http://www.cdsco.nic.in/html/GCP1.html. Accessed on 20 February 2023.
Shaikh Z, Pathak R, BG Prasad. socio-economic scales for 2016. Int J Community Med Public Health. 2017; 4(4):997-9.
Kuppuswamy A. A study of prescription pattern in the drug therapy of chronic kidney disease. Int J Pharmacol Res. 2017;7(4):81-7.
Rajapurkar MM, John GT, Kirpalani AL, Abraham G, Agarwal SK, Almeida AF, et al. What do we know about chronic kidney disease in India: first report of the Indian CKD registry. BMC Nephrol. 2012;13(1):10.
Ahlawat R, D'Cruz S, Tiwari P. Drug utilization pattern in chronic kidney disease patients at a tertiary care public teaching hospital: Evidence from a cross-sectional study. J Pharma Care Health Sys. 2015;3(149):2376-419.
Devi DP, George J. Diabetic nephropathy: Prescription trends in tertiary care. Indian J PharmSci. 2008;70(3): 374.
Al-Ramahi R. Medication prescribing patterns among chronic kidney disease patients in a hospital in Malaysia. Saudi J Kidney Dis Transplant. 2012;23(2): 403.
Kazancioğlu R. Risk factors for chronic kidney disease: an update. Kidney Int Suppl. 2013;3(4):368-71.
Chakraborty S, Ghosh S, Banerjea A, De RR, Hazra A, Mandal SK. Prescribing patterns of medicines in chronic kidney disease patients on maintenance hemodialysis. Indian J Pharmacol. 2016;48(5):586.
Gallieni M, Cancarini G. Drugs in the elderly with chronic kidney disease: beware of potentially inappropriate medications. Nephrol Dial Transplant. 2015;30(3):342-4.
Jain D, Green JA. Health literacy in kidney disease: Review of the literature and implications for clinical practice. World J Nephrol. 2016;5(2):147.
Wright JA, Wallston KA, Elasy TA, Ikizler TA, Cavanaugh KL. Development and results of a kidney disease knowledge survey given to patients with CKD. Am J Kidney Dis. 2011;57(3):387-95.
Zeng X, Liu J, Tao S, Hong HG, Li Y, Fu P. Associations between socioeconomic status and chronic kidney disease: a meta-analysis. J Epidemiol Community Health. 2018;72(4):270-9.