Assessing Individual Medication Adherence among Chronic Kidney Disease Patients: A Multi-centered Study

Abstract

Aims: This study aims to identify differences in outcomes of assessing overall versus individual adherence and factors associated with adherence to medication therapy in chronic kidney disease patients. Study Design:  This is a cross-sectional study. Place and Duration of Study: Nephrology Clinic, Universiti Kebangsaan Malaysia Medical Centre and Ministry of Health Hospitals between June 2018 and June 2019. Methodology: We included 491 patients (243 men, 248 women); average age of 54.5 (±14.6) years with chronic kidney disease and prescribed at least one medication, using a validated questionnaire. Results: Patients were prescribed an average of 7.0±2.4 medications. Majority were categorized as adherent (n=404, 82.3%) based on an overall assessment. In contrast, only 27.5% (n=135) were adherent when medications were assessed individually. Based on individual medication assessment, a multivariate logistic regression demonstrated patients aged >55 years were 2.3 times more likely to be adherent toward medicines (P=.001). Those with <3 comorbidities and <7 medications increased the odds of adherence by 2.1 (P=.002) and 2.2 (P=.001) times respectively. Having a drug knowledge score >80% increase the odds of adherence by 8.7 times compared to their counterparts (P<.01). Conclusion: Potential strategies for targeted management should be developed in order to remove barriers towards medication adherence in chronic kidney disease patients.