Do the patient education program and nurse-led telephone follow-up improve treatment adherence in hemodialysis patients? A randomized controlled trial

Abstract

Background End-Stage Renal Disease (ESRD) is the final and permanent stage of Chronic Kidney Disease (CKD). Hemodialysis (HD) is the most common treatment for CKD. To have desirable therapeutic outcomes, patients have to adhere to a specific therapeutic regimen that reduces the hospitalization rate and side-effects of HD. The present study aimed to determine the effects of the patient education program and nurse-led telephone follow-up on adherence to the treatment in hemodialysis patients. Methods This is a randomized controlled trial in which a total of 66 patients were recruited using convenience sampling and then randomly assigned to two groups of control (n = 33) and intervention (n = 33). Data were collected using a demographic questionnaire, the laboratory results record sheet, and the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ), which included four dimensions of HD attendance, medication use, fluid restrictions, and diet recommendations. The intervention group received a patient education program and nurse-led follow-up services through telephone communication and the Short Message Service (SMS) for 3 months. All participants filled in the questionnaire before and after the intervention. Data were analyzed using IBM SPSS Statistics for Windows, version 25 (IBM Corp., Armonk, N.Y., USA). Results The results showed a significant difference in the mean scores of HD attendance, medication use, fluid restrictions, and diet recommendations between the two groups immediately, 1 month, and 3 months after the intervention (p < .001). The results also indicated a significant difference in the mean scores of four dimensions during the four-time points of measurement in the intervention group (P < 0.0005). Therefore, the level of treatment adherence in the intervention group was higher than in the control group. Moreover, there was a significant difference in the mean score of laboratory values between the two groups after the intervention, except for the level of serum sodium (P = 0.130). Conclusion Implementation of the patient education program and nurse-led follow-up can lead to better adherence to hemodialysis in four dimensions of HD attendance, medication use, fluid restrictions, and dietary recommendations in HD patients. Trial registration IRCT registration number: IRCT20190127042512N1; Registration date: 2020-09-12; Registration timing: retrospectively registered: Last update: 2020-09-12.

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

“…The mean pre-pandemic scores of ESRD-AQ sub-domains in this study were consistent with those reported by Naalweh et al [ 15 ] except for the mean HD attendance and medication adherence scores which were lower than Naalweh's study (268.3 vs. 296.36, and 160.2 vs 184.32, respectively) [ 15 ]. In contrast, our mean scores of the total adherence behavior and its sub-domains were all higher than those reported by Arad et al [ 22 ] which reported a total adherence score of 513.6 compared to 919.8 in our study. Furthermore, non-adherence behaviors among ESRD patients showed wide variations in the literature ranging from 2% to 80.4% for dietary restrictions, 9.7%–75.3% for fluid restrictions, 15.4%–99% for medical prescriptions, and to HD attendance as 33.6%.…”

Are Cooling Dialysate and Patient Education Can Decrease Intradialytic Hypotension?

“…In the current study it was determined that the prevalence of IDH significantly decreased after patient education and cooling of the dialysate (Figure 1). This is in line with Arad et al, (2021) Besides patient education for reducing IDH, another important intervention in this study is dialysis fluid cooling. In a meta-analysis conducted on this subject, it was determined that low-temperature dialysates reduced the rate of IDH development by 70% (Mustafa et al, 2016;Rad et al, 2021).…”

“…In this way, satisfaction, quality of life, and independence are increased. Besides complications, anxiety, and cost are reduced (Arad et al, 2021). Nephrological nurses play a critical role in preventing and managing IDH.…”

The application effect of the trans-theoretical model of behavior change in diabetic kidney disease patients treated with maintenance hemodialysis

“…It implied that the nursing method combined with TTM of behavior change can relieve patients' bad psychological state, increase the compliance to fluid intake and also effectively reduce the incidence rate of dialysis-associated acute complications. Starting from the point that research objects show some behaviors unfavorable for the treatment, TTM of behavior change aims to guide the research objects to change their bad behaviors, take intervention measures by stage, and strengthen new beneficial behaviors until the objective of health behaviors is realized [24][25][26][27][28][29][30][31].…”