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

Abstract

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.

Role of a Respiratory Therapist in Improving Adherence to Positive Airway Pressure Treatment in a Pediatric Sleep Apnea Clinic

“…11 In patients with any chronic illness, education improves outcomes. [12][13][14][15] Education of patients and caregivers regarding the medical necessity of PAP, how to use and clean the equipment, and addressing barriers causing poor adherence improves adherence to PAP treatment in adults with OSDB. 15 Healthcare professionals, including physicians, nurses, respiratory therapists (RTs), and psychologists, can provide PAP education for pediatric patients and their families.…”

Starting on haemodialysis: A qualitative study to explore the experience and needs of incident patients

“…As little is known about the psychosocial issues during this acute duration, these substantial figures accentuate a need for further research. However, current studies delving into mortality risks of new patients predominantly focused on clinical predictors or factors (Atkinson, Oberal, Neu, Fivush, & Parekh, 2010;Lee et al, 2009;Wolf et al, 2007), while psychological intervention studies mainly targeted adherence behaviours rather than psychological responses (Katzir et al, 2010;Lamping & Campbell, 1990;Welch & Thomas-Hawkins, 2004). Studies examining psychosocial issues, concerns and needs during the initial months of treatment thus warrant attention since current frameworks are insufficient to fully address the incident patient group's needs.…”

Erythropoiesis Stimulating Agents and Anaemia of End-Stage Renal Disease

“…If the patient is self-administering (e.g. for peritoneal dialysis patients or patients with non-dialysis dependent chronic renal failure) poor adherence or compliance to therapy must be excluded [23,24]. If there is any doubt about the possibility of iron deficiency, markers of iron status should determined.…”