Non-adherence to hemodialysis regimens among patients on maintenance hemodialysis in sub-Saharan Africa: an example from Cameroon

Abstract

Background Non-adherence (NA) to hemodialysis regimens is one of the contributors to the high morbidity and mortality observed in patients with end-stage kidney disease (ESKD). We aimed to determine the prevalence and predictors of NA to hemodialysis (HD) regimens among patients on maintenance HD in Cameroon. Methods A cross-sectional study in two HD centers in Cameroon was conducted from January to February 2016. Consenting patients on HD for ≥3 months were included. NA to fluid restriction was defined as a mean interdialytic weight gain (IDWG) in the past month >5.7% of the dry weight, NA to dietary restriction as a pre dialysis serum phosphorus >5.5 mg/dl in a patient on phosphate binders and who is well-nourished, and NA to HD sessions as skipping at least one session in the past month. The study was approved by the institutional ethics board. Results A total of 170 (112 males) participants with a median age of 49 years (range 14–79) were included. The median dialysis vintage was 35 months (range 3–180 months). The prevalence of NA was 15.3% to fluid restriction, 26.9% to dietary restriction, and 21.2% to dialysis sessions. Age ≤49 years ( p = .006, OR: 5.07, 95% CI: 1.59–16.20) and unmarried status ( p = .041, OR: 2.63, 95% CI: 1.04–6.66) were independently associated with NA to fluid restrictions. No factor was associated with NA to dietary restrictions and HD sessions. Conclusions NA to HD regimens is common amongst patients in Cameroon. Younger age and being unmarried were the predictors of NA to fluid restriction.

Monitoring Frequency of Haemoglobin, Calcium and Phosphorus and the Impact on Correction in Patients on Maintenance Haemodialysis in Douala-Cameroon

“…These results were almost similar to those of Abderraman et al in Senegal in 2015 (63.7% and 60.9% respectively) [25]. Possible explanations for these low rates are; first the high level of non-adherence to dietary restrictions in our setting as reported by Musaga et al [26] and secondly, the low use of oral phosphate binders, with only 37.7% of our participants using it throughout the study.…”

Effect of self‐care intervention for controlling interdialytic weight gain among patients on haemodialysis: A systematic review and meta‐analysis

“…Existing knowledge indicates that non‐compliance is a critical problem in patients on haemodialysis (Halle et al, 2020; Ozen et al, 2019). Compliance or adherence to self‐care refers to the extent to which an individual engages in self‐care following the recommendations of healthcare professionals (Sabate, 2003).…”

“…Compliance or adherence to self‐care refers to the extent to which an individual engages in self‐care following the recommendations of healthcare professionals (Sabate, 2003). Studies have investigated whether compliance or adherence could be improved by using a self‐care or self‐management approach (Halle et al, 2020; Ozen et al, 2019; Zimbudzi et al, 2018). By performing self‐care, patients are more likely to gain skills and develop self‐efficacy or confidence, which can help them to adapt to their chronic illness and maintain their health as great as possible (Belil et al, 2018).…”

Effect of Self‐Determination Theory on Knowledge, Treatment Adherence, and Self‐Management of Patients with Maintenance Hemodialysis

“…Compliance was evaluated by the treatment compliance scale for maintenance hemodialysis patients with end-stage renal disease [ 7 ], which is mainly evaluated by 23 questionnaire items and 4 dimensions, mainly from four aspects: dietary compliance, fluid intake compliance, dialysis regimen compliance, and medication compliance. The Likert 5-grade scoring method was used for each item, and the better the compliance, the better the score.…”