Compliance in Hemodialysis Patients: A Multivariate Regression Analysis

Morduchowicz, G.; Sulkes, Jaqueline; Aizic, Silvia; Gabbay, Uri; Winkler, J.; Boner, G

doi:10.1159/000187355

Cited by 50 publications

(37 citation statements)

References 3 publications

(3 reference statements)

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“…This research adds to the literature that confirms significant relationships between low adherence to PBM and ethnicity (Curtin et al, 1999;Leggat et al, 1998;Morduchowicz et al, 1993) while also specifying that such nonadherence in this sample was intentional.…”

Section: Discussionmentioning

confidence: 54%

Profiling patient attitudes to phosphate binding medication: A route to personalising treatment and adherence support

Chater

Parham

Riley

et al. 2014

Psychology & Health

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Objective: Nonadherence to phosphate binding medication (PBM) compromises the efficacy of treatment for chronic kidney disease (CKD), but its causes are poorly understood. This study sought to explore patient attitudes towards PBM and to evaluate the utility of the Necessity-Concerns Framework for understanding adherence to PBM. Design: A sample of two hundred and twenty-one dialysis patients currently prescribed PBM were surveyed from eight UK renal units. Main Outcome Measures: Demographic data and clinical information, alongside the Beliefs about Medication Questionnaire (BMQ) and the Medication Adherence Report Scale (MARS) were reported. Results: Low adherence to PBM was predicted by reduced beliefs in personal need for PBM (OR = .34; 95% CI: .14-.83; p < .05), and increased concerns about PBM (OR = 3.17; 95% CI: 1.87-5.37; p < .001). Patients were categorised into attitudinal groups based on their beliefs about PBM and being 'skeptical' of PBM (low necessity beliefs, high concerns) was most associated with low adherence. Conclusion:Strategies to improve adherence to PBM should aim to elicit and address patients' beliefs about their personal need for PBM and their concerns about this medication.

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Section: Discussionmentioning

confidence: 54%

Profiling patient attitudes to phosphate binding medication: A route to personalising treatment and adherence support

Chater

Parham

Riley

et al. 2014

Psychology & Health

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“…(1) IDWG as a measure of nonadherence: For decades it has been emphasized that adherence to fluid restriction is necessary to reduce IDWG, and IDWG has been equated with nonadherence [28,29,30,31,32,33,34,35,36,37,38] (in an oversimplified disregard of the thirst mechanism, as specified below).…”

Section: Interdialytic Weight Gain: Reported Causes and Consequencesmentioning

confidence: 99%

Significance of Interdialytic Weight Gain versus Chronic Volume Overload: Consensus Opinion

et al. 2013

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Predialysis volume overload is the sum of interdialytic weight gain (IDWG) and residual postdialysis volume overload. It results mostly from failure to achieve an adequate volume status at the end of the dialysis session. Recent developments in bioimpedance spectroscopy and possibly relative plasma volume monitoring permit noninvasive volume status assessment in hemodialysis patients. A large proportion of patients have previously been shown to be chronically volume overloaded predialysis (defined as >15% above ‘normal' extracellular fluid volume, equivalent to >2.5 liters on average), and to exhibit a more than twofold increased mortality risk. By contrast, the magnitude of the mortality risk associated with IDWG is much smaller and only evident with very large weight gains. Here we review the available evidence on volume overload and IDWG, and question the use of IDWG as an indicator of ‘nonadherence' by describing its association with postdialysis volume depletion. We also demonstrate the relationship between IDWG, volume overload and predialysis serum sodium concentration, and comment on salt intake. Discriminating between volume overload and IDWG will likely lead to a more appropriate management of fluid withdrawal during dialysis. Consensually, the present authors agree that this discrimination should be among the primary goals for dialysis caretakers today. In consequence, we recommend objective measures of volume status beyond mere evaluations of IDWG.

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“…The average chronic dialysis patient has to take 6–10 different medications daily. In one study, only 39% of hemodialysis (HD) patients and 57% of continuous ambulatory peritoneal dialysis (CAPD) patients could recall all of their medications [4]. The extent of dialysis patient noncompliance appears to differ by drug class, ascertained in one study by electronic pill counting to be 47% for antihypertensive drugs and 72% for phosphate-binding agents [5].…”

Section: Introductionmentioning

confidence: 99%

“…The extent of dialysis patient noncompliance appears to differ by drug class, ascertained in one study by electronic pill counting to be 47% for antihypertensive drugs and 72% for phosphate-binding agents [5]. An association between fluid restriction, inter-dialysis weight gain and compliance with medications has been reported [4]. Together with gender, ethnic origin and education, compliance with medications affects patient serum phosphorus and potassium levels [5].…”

Section: Introductionmentioning

confidence: 99%

Medication Apprehension and Compliance among Dialysis Patients – A Comprehensive Guidance Attitude

et al. 2009

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Background: Compliance with treatment regimens is a continuing challenge for chronic dialysis patients and their medical caregivers. Poor patient adherence to prescribed medications can adversely affect treatment outcome. Study Design: In this pre- versus post-intervention study, 89 chronic dialysis patients [75 hemodialysis (HD), 14 continuous ambulatory peritoneal dialysis (CAPD); mean age 62.7 ± 12.39 years, 34 females] responded to a written questionnaire designed to assess knowledge about and compliance with 5 groups of prescribed medications: metabolic drugs, antihypertensives, cardiac-supporting agents, peptic disease therapy and hematological replacement therapy. Mode of intake, storage, means of supply and source of information for each class of drug were also assessed. Patients then received both oral and written instructions regarding their prescribed medications (intervention). This information was repeated 3 months later. Six months after the intervention, patients were re-administered the questionnaires. Response to the questionnaires and laboratory data were compared prior to and following the intervention. Results: Overall, compliance with prescribed medications significantly improved following the intervention, from 89 to 95.7%, p = 0.0007. This relative improvement was greater in HD than CAPD patients (27 vs. 2%, p < 0.0001). Improvement in compliance was associated with lower initial scores, fewer years of education, and longer dialysis vintage. Compared to baseline values, post-intervention blood hemoglobin, hematocrit, mean corpuscular volume, ferritin and Ca levels were significantly improved. Conclusions: Dialysis patients appear to benefit from receiving comprehensive guidance about medications, in terms of compliance with medications and blood chemistry and hematology measures.

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Compliance in Hemodialysis Patients: A Multivariate Regression Analysis

Cited by 50 publications

References 3 publications

Profiling patient attitudes to phosphate binding medication: A route to personalising treatment and adherence support

Profiling patient attitudes to phosphate binding medication: A route to personalising treatment and adherence support

Significance of Interdialytic Weight Gain versus Chronic Volume Overload: Consensus Opinion

Medication Apprehension and Compliance among Dialysis Patients – A Comprehensive Guidance Attitude

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