Assessment of Treatment Adherence and Its Predictors in Maintenance Hemodialysis Patients

Abstract

Introduction: End Stage renal disease (ESRD) is an irreversible progressive condition responsible for high morbidity and mortality. Long term treatment and lifestyle modifications are difficult to adapt which significantly impairs treatment adherence and quality of life.  Aim: To assess the treatment adherence of ESRD patients undergoing maintenance hemodialysis.  Methodology: A prospective, observational, comparative, multicentre study was done for 10 months. Demographic and clinical parameters were collected from medical records and their treatment adherence was assessed using End-Stage Renal Disease-Adherence Questionnaire (ESRD-AQ). The responses were scored and identified the patients having low adherence. Results: A total of 121 patients were enrolled in the study with a mean age of 62.14± 11.41 years. Dietary adherence and fluid restriction were observed at 63.33% and 60.33% respectively. Adherence to hemodialysis sessions indicated 97% while towards medication was 67.77%. A significant correlation existed between clinical biomarkers with specific adherence scores which suggest the validity of reported adherence scores. Awareness of patients regarding the diet, fluids, and, medications through patient counselling was found to be very effective in improving the adherence in ESRD populations.  Conclusion: The study concludes that a huge number of hemodialysis patients are non-adherent to the treatment and the pharmacist role is pivotal in improving treatment adherence and patient compliance.