Treatment Adherence of Patients with Chronic Kidney Disease: an Integrative Literature Review

Abstract

Chronic kidney disease is a serious health problem worldwide and the adherence to treatment is fraught with difficulty and needs to be understood. The objective of this study is to analyze the scientific production on the main factors that influence treatment adherence of patients with chronic kidney disease undergoing hemodialysis or peritoneal dialysis. An integrative literature review was performed, selecting articles published in Portuguese, English, and Spanish, between 2007 and 2017, from the Scielo, Regional Portal of the Virtual Health Library and PubMed databases. Through four combinations of descriptors and booleans, 1181 files were found. After applying the exclusion criteria, 20 articles remained. Most of the studies were in English and were empirical, cross-sectional, quantitative, and in the area of medical sciences. They indicate different modalities that determine adherence (diet therapy, pharmacology, and therapy) and various biosociodemographic factors (age, gender, education, cognition, knowledge about treatment, socioeconomic status, access to transport and treatment, pain, and faith) and psychosocial factors (quality of life, well-being, mental health, personality, and social and family support). It is concluded that the factors that strengthen, as well as impede, patients' treatment adherence should be recognized to guide decision-making regarding the patient's unique therapeutic planning.