Adherence to drug treatments in patients with chronic kidney disease on hemodialysis

Abstract

Chronic Kidney Disease is associated with the use of polypharmacy and is associated with increased risk of adverse events, drug interactions and decreased adherence to drug treatment. The aim of the present study was to evaluate treatment adherence in patients with chronic kidney disease undergoing hemodialysis. We conducted a cross-sectional, descriptive and analytical survey of all patients enrolled and followed in the Nephrology services of the Ijuí Charity Hospital and the Kidney Clinic, attached to the Santo Ângelo Hospital, from January to June 2017. Data collection was performed through an individual interview, using a structured and validated questionnaire. Depression was assessed by applying the Beck Depression Inventory and adherence was by the Morisky Adhesion Scale. 184 patients were interviewed, and among those interviewed, 66.2% had low adherence. Infarction, repetitive infections and depression were factors statistically significantly associated with poor adherence, as well as the use of more than six medications. Performing physical activities was associated with a greater adherence to medication use. 45.7% of patients responded that they had at some point forgotten to take their medication, and 42.4% stopped taking their medication when they felt their symptoms were under control. Therefore, health education actions, as well as pharmacotherapeutic follow-up of these patients, should be performed with a focus on improving adherence and quality of life, with a view to increasing survival.

Factores asociados a la adherencia a la hemodiálisis y al tratamiento farmacológico en Perú

“…Para la adherencia al tratamiento farmacológico, se identificó que la gran mayoría de los pacientes no fueron adherentes a su medicación dado que sus puntajes oscilaron entre mediana y baja adherencia. Este resultado concuerda con lo expuesto por otros investigadores 6,15 quienes refieren que más de la mitad de su población logró mediana 5 y baja adherencia 6,15 . También se encontró diferencia con un estudio de Estados Unidos donde los mayores porcentajes se establecieron en alta adherencia farmacológica 16 a pesar de que la mayoría tenía prescrito 9 medicamentos, esto puede deberse a que en este país desarrollado tiene un mayor seguimiento de estos pacientes.…”

“…En Egipto, la pandemia de COVID-19 afectó negativamente la adherencia de los pacientes a la HD y al tratamiento farmacológico 5 . En Brasil, evaluaron la adherencia farmacológica en pacientes en HD encontrando que el 62,2% tuvo baja adherencia, mientras que solo el 33,8% mostró una alta adherencia al tratamiento, además mostraron que la disminución de adherencia al tratamiento tenía relación con factores propios de la persona (edad, sexo, y nivel educativo) 6 . En Perú, un estudio de pacientes con ERC en estadio 5, evidenció que 1 de cada 4 pacientes tuvo baja adherencia al tratamiento con hemodiálisis y concluyeron que residir lejos era el principal motivo para la ausencia de adherencia 7 .…”

The relationship between fatigue, pruritus, and thirst distress with quality of life among patients receiving hemodialysis: a mediator model to test concept of treatment adherence

“…Moreover, the absence of hemodialysis sessions increases waste products in the body 48 and increases the mortality rate 42 . Contributing factors to poor TA include the large number and unpleasant taste of some medications, the complexity of treatments 49 , and the side effects of medications 50 , 51 .…”