Renal pharmacists’ perceptions and current practices of assessing medication adherence in dialysis patients

Abstract

Perception scores, scale reliability, and responses to current practices questionnaire. Results 41 pharmacists completed the survey (response rate, 91.1%). The majority (91.9%, n = 34; median = 8.0) agreed patients were nonadherent to medication. Time constraints (43.8%, n = 14) and hospital support (31.3%, n = 10) were perceived as barriers to assessment. Objective blood monitoring was frequently used to determine nonadherence (57.1%, n = 16), whereas subjective interviews were rarely conducted (27.6%, n = 8). Though all pharmacists support the presence of dedicated pharmacist for assessing adherence (100.0%, n = 33), only 24.2% were actually performing this function. Conclusion Pharmacists were rarely assigned for adherence assessment in dialysis settings. Established self-report methods were under-utilised compared to objective methods. Future research should investigate the effectiveness of pharmacists' involvement in facilitating adherence promotion and early identification of medication-related issues in dialysis patients.

Medication adherence assessment practices in dialysis settings: A survey of renal nurses’ perceptions

“…We observed that current adherence assessment practices are limited and that the methods used to monitor nonadherence behaviour, such as medication history taking, and medication reviews and reconciliation by pharmacists, were only occasionally conducted, whereas objective blood monitoring was a routine practice in most settings. A recent survey on renal pharmacists’ perceptions corroborated the study's findings on current adherence assessment practices in dialysis settings (Ghimire et al., ). Objective blood monitoring in patients undergoing dialysis is mainly conducted to ensure that the dialysis prescription, that is, the time and type of the dialysis treatments, is optimal.…”

“…During the thorough literature search, we could not identify any validated tools that particularly measured dialysis nurses’ perceptions regarding adherence assessment practices. Hence, we adapted a previously developed survey instrument that measured renal pharmacists’ perceptions and practices of assessing adherence in dialysis settings (Ghimire, Banks, Jose, Castelino, & Zaidi, ). To briefly describe the instrument, it comprised seven sections that explored demographics, perceptions of the prevalence of, and contributors to nonadherence, the perceived effectiveness of methods used to detect nonadherence, barriers to adherence assessment and participants’ confidence in assessing adherence.…”

Adherence assessment practices in haemodialysis settings: A qualitative exploration of nurses and pharmacists' perspectives

“…However, these are often less explored aspects of patient adherence reported in medical literatures. In two separate surveys (Ghimire, Banks, Jose, Castelino, & Zaidi, 2017, renal nurses and pharmacists reported time constraints , lack of support from hospital administration , and patient's unwillingness to discuss medication-related issues with nurses (Ghimire et al, 2018) as potential barriers to assessing adherence during routine care.…”

Practices and pitfalls in medication adherence in hemodialysis settings – a focus-group study of health care professionals

“…Previous studies of HCPs' practice for assessing adherence in hemodialysis settings primarily recruited nurses and pharmacists' [6][7][8]. The studies by Ghimire et al describe that time restraints and shortage of resource combined with insufficient training and lack of awareness challenge adherence assessment in Australia.…”

“…The studies by Ghimire et al describe that time restraints and shortage of resource combined with insufficient training and lack of awareness challenge adherence assessment in Australia. Multidisciplinary support from pharmacists, nurses and physicians working together with active patient involvement is recommended to improving patient adherence to treatment [6][7][8]. Gilad et al interviewed physicians, nurses and patients about their attitudes and approaches to medical care in a dialysis setting in Israel [9].…”