Adherence to hemodialysis and medical regimens among patients with end-stage renal disease during COVID-19 pandemic: a cross-sectional study

Abstract

Background Adherence of patients with End-Stage Renal Disease (ESRD) to Hemodialysis (HD), prescribed medications, diet and fluid restrictions is essential to get the desirable outcome and prevent complications. During COVID-19 pandemic, ESRD patients became more concerned with attending the HD sessions and following the protective measures because of the potential for increased susceptibility to COVID-19. The aim of this study was to evaluate the impact of the pandemic on patients' adherence to HD and medical regimens. Methods Two hundred five ESRD patients on HD were interviewed with the ESRD Adherence Questionnaire (ESRD-AQ) and the Fear-of-COVID-19 Scale (FCV-19S). Clinical and laboratory correlates of adherence were retrieved from patients' records. Results Self-reported adherence to HD showed that 19.5% were not adherent to HD during the pandemic compared to 11.7% before the pandemic (p < 0.001), with a significant agreement with the actual attendance of HD sessions (Kappa = 0.733, p < 0.001). Twenty-five patients (12.2%) had a history of COVID-19. The FCV-19S had a mean score of 18.8 and showed significant positive correlations with the pre-dialysis phosphorus and potassium. Multivariate analysis showed that the main predictors of non-adherence were the history of COVID-19, understanding and perception scores, and the Fear-of-COVID score. Conclusions The COVID-19 pandemic adversely affected the adherence of ESRD patients to HD and medical regimen. Strategies to mitigate patients' fears of COVID-19 and improve their understanding and perceptions of adherence to HD and medical regimen should be adopted in HD centers during the pandemic.

Digital Healthy Diet Literacy and Fear of COVID-19 as Associated with Treatment Adherence and Its Subscales among Hemodialysis Patients: A Multi-Hospital Study

“…Our study shows that fear of COVID-19 is associated with lower scores of treatment adherence. This finding is in line with a prior study, which found that insufficient knowledge and low perception scores, as well as a high fear of COVID-19, were the primary predictors of non-adherence [ 15 ]. Furthermore, the fear of COVID-19 also increased the chemotherapy postponement rate in cancer patients [ 52 ].…”

“…The responses ranged from 0 to 200. The overall score ranges from 0 to 1200, with higher scores indicating better TA [ 15 , 36 , 37 ].…”

“…The COVID-19 pandemic affects the adherence of ESRD patients to hemodialysis and medication regimens, resulting in a marked increase in the non-adherence rate from 11.7% to 19.5% [ 15 ]. A higher fear of COVID-19 score predicts a higher rate of non-adherence to treatment [ 15 ].…”

“…The COVID-19 pandemic affects the adherence of ESRD patients to hemodialysis and medication regimens, resulting in a marked increase in the non-adherence rate from 11.7% to 19.5% [ 15 ]. A higher fear of COVID-19 score predicts a higher rate of non-adherence to treatment [ 15 ]. Increased levels of physical activity are correlated with health-related quality of life in hemodialysis patients (HRQOL) [ 16 ], and non-compliance to drug therapy may be associated with worse HRQOL [ 17 ].…”

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

“…En general, 122 (55,5%) pacientes tuvieron una buena adherencia, 89 (40,5%) tuvieron una adherencia moderada y 9 (4,1%) tuvieron un comportamiento de adherencia deficiente 4 . 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 .…”