Evaluation of medication adherence in chronic kidney disease patients with and without hemodialysis

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL
Amra Ahsan, Shaurya Kaul, NarinderPal Singh, Dinesh Khullar, AnishKumar Gupta
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引用次数: 0

Abstract

Background: Poor long-term adherence and persistence to pharmacological therapy is widely acknowledged as one of the primary clinical difficulties in the management of chronic diseases such as chronic kidney disease (CKD). The present study was aimed to measure treatment adherence using the Morisky Medication Adherence Scale (MMAS)-8 questionnaire in CKD patients with or without hemodialysis. Methodology: It was a cross-sectional study conducted in 120 clinically stable CKD patients with Stage 3 onward with or without hemodialysis. The sociodemographic and clinical characteristics of participants were collected in a predesigned format. Individual participants were scheduled for interviews and asked to complete inventory questionnaires. Medication adherence was assessed using a validated diagnostic tool MMAS-8 questionnaire. Results: Out of 120 individuals, the average number of medicines prescribed per prescription was 5.63 ± 2.22 and 4.65 ± 1.72 in the dialysis and nondialysis groups, respectively. Patients on dialysis had a higher pill burden than nondialysis patients, with more than three-fourths (78.3%) of them taking more than five medications every prescription. Low, moderate, and good adherence were reported in 61.7% (n = 37) versus 26.7% (n = 16), 33.3% (n = 20) versus 71.7% (n = 43), and 5% (n = 3) versus 1.6% (n = 1) of patients with and without dialysis, respectively, in MMAS-8. The most often reported nonadherence behaviors were forgetting to take medications, forgetting to pack medications while traveling, and feeling pressured to follow a treatment plan. There was an association between the dialysis and nondialysis groups in education level, employment, and pill load among patients with low adherence. Conclusion: Majority of the respondents (more than 90%) reported low-to-moderate adherence in both dialysis and nondialysis populations. Physicians and all other health-care professionals should work together to reduce the obstacles to good adherence by enhancing communication, reducing the burden of taking a lot of pills, and, if possible, by occasionally checking on patient adherence when there is suspicion of poor adherence.
有和没有血液透析的慢性肾病患者药物依从性的评价
背景:长期依从性差和对药物治疗的坚持被广泛认为是慢性肾病(CKD)等慢性疾病治疗的主要临床困难之一。本研究旨在使用Morisky药物依从性量表(MMAS)-8问卷来衡量有或没有血液透析的CKD患者的治疗依从性。方法:这是一项横断面研究,对120例临床稳定的3期CKD患者进行了血液透析或不进行血液透析。以预先设计的格式收集参与者的社会人口学和临床特征。个别参与者被安排进行访谈,并被要求完成问卷调查。使用经过验证的诊断工具MMAS-8问卷评估药物依从性。结果:120例患者中,透析组和非透析组的平均处方药物数量分别为5.63±2.22和4.65±1.72。透析患者的药物负担高于非透析患者,超过四分之三(78.3%)的患者在每次处方中服用超过五种药物。在MMAS-8中,61.7% (n = 37)对26.7% (n = 16), 33.3% (n = 20)对71.7% (n = 43), 5% (n = 3)对1.6% (n = 1)的透析患者报告了低、中度和良好的依从性。最常见的不遵医嘱行为是忘记服药,旅行时忘记打包药物,以及在遵循治疗计划时感到有压力。在低依从性患者中,透析组和非透析组在教育水平、就业和药物负荷方面存在关联。结论:在透析和非透析人群中,大多数应答者(超过90%)报告了低至中等依从性。医生和所有其他保健专业人员应共同努力,通过加强沟通,减少服用大量药物的负担,并在可能的情况下,在怀疑患者的依从性较差时,偶尔检查患者的依从性,以减少良好依从性的障碍。
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来源期刊
Indian Journal of Medical Specialities
Indian Journal of Medical Specialities MEDICINE, GENERAL & INTERNAL-
自引率
16.70%
发文量
51
期刊介绍: The Indian Journal of Medical Specialities is an all-encompassing peer-reviewed quarterly journal. The journal publishes scholarly articles, reviews, case reports and original research papers from medical specialities specially pertaining to clinical patterns and epidemiological profile of diseases. An important highlight is the emphasis on undergraduate and postgraduate medical education including various aspects of scientific paper-writing. The journal gives priority to research originating from the developing world, including from the tropical regions of the world. The journal also publishes special issues on health topics of current interest. The Indian Journal of Medical Specialities is one of the very few quality multispeciality scientific medical journals.
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