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. 2017 May 22;18(1):167.
doi: 10.1186/s12882-017-0583-9.

Medication adherence perspectives in haemodialysis patients: a qualitative study

Saurav Ghimire  1 , Ronald L Castelino  1   2   3 , Matthew D Jose  4   5 , Syed Tabish R Zaidi  6
Affiliations

Medication adherence perspectives in haemodialysis patients: a qualitative study

Saurav Ghimire et al. BMC Nephrol. .

Abstract

Background: End-stage kidney disease patients undergoing haemodialysis are prescribed with multiple complex regimens and are predisposed to high risk of medication nonadherence. The aims of this study were to explore factors associated with medication adherence, and, to examine the differential perspectives on medication-taking behaviour shown by adherent and nonadherent haemodialysis patients.

Methods: A qualitative exploratory design was used. One-on-one semi-structured interviews were conducted with 30 haemodialysis patients at the outpatient dialysis facility in Hobart, Australia. Patient self-reported adherence was measured using 4-item Morisky Green Levine scale. Interview transcripts were thematically analysed and mapped against the World Health Organization (WHO) determinants of medication adherence.

Results: Participants were 44-84 years old, and were prescribed with 4-19 medications daily. More than half of the participants were nonadherent to their medications based on self-reported measure (56.7%, n = 17). Themes mapped against WHO adherence model comprised of patient-related (knowledge, awareness, attitude, self-efficacy, action control, and facilitation); health system/ healthcare team related (quality of interaction, and mistrust and collateral arrangements); therapy-related (physical characteristics of medicines, packaging, and side effects); condition-related (symptom severity); and social/ economic factors (access to medicines, and relative affordability).

Conclusions: Patients expressed a number of concerns that led to nonadherence behaviour. Many of the issues identified were patient-related and potentially modifiable by using psycho-educational or cognitive-behavioural interventions. Healthcare professionals should be more vigilant towards identifying these concerns to address adherence issues. Future research should be aimed at understanding healthcare professionals' perceptions and practices of assessing medication adherence in dialysis patients that may guide intervention to resolve this significant issue of medication nonadherence.

Keywords: End-stage kidney disease; Haemodialysis; Medication adherence; Patients’ perspectives; Qualitative study.

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References

    1. Liyanage T, Ninomiya T, Jha V, Neal B, Patrice HM, Okpechi I, Zhao MH, Lv J, Garg AX, Knight J, et al. Worldwide access to treatment for end-stage kidney disease: a systematic review. Lancet. 2015;385(9981):1975–1982. doi: 10.1016/S0140-6736(14)61601-9. - DOI - PubMed
    1. Avorn J. The $2.6 billion pill--methodologic and policy considerations. N Engl J Med. 2015;372(20):1877–1879. doi: 10.1056/NEJMp1500848. - DOI - PubMed
    1. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353(5):487–497. doi: 10.1056/NEJMra050100. - DOI - PubMed
    1. Ghimire S, Castelino RL, Lioufas NM, Peterson GM, Zaidi ST. Nonadherence to medication therapy in Haemodialysis patients: a systematic review. PLoS One. 2015;10(12) doi: 10.1371/journal.pone.0144119. - DOI - PMC - PubMed
    1. Cleemput I, Kesteloot K, Vanrenterghem Y, De Geest S. The economic implications of non-adherence after renal transplantation. PharmacoEconomics. 2004;22(18):1217–1234. doi: 10.2165/00019053-200422180-00006. - DOI - PubMed

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