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Medication regimen complexity and adherence in haemodialysis patients: an exploratory study


Ghimire, S and Peterson, GM and Castelino, RL and Jose, MD and Zaidi, STR, Medication regimen complexity and adherence in haemodialysis patients: an exploratory study, American Journal of Nephrology, 43, (5) pp. 318-324. ISSN 0250-8095 (2016) [Refereed Article]

Copyright Statement

2016 S. Karger AG, Basel

DOI: doi:10.1159/000446450


Background: The impact of medication regimen complexity on adherence in hemodialysis patients is unknown. We investigated regimen complexity, perceived burden of medicines (PBM) and health-related quality of life (HR-QoL) as potential predictors of adherence.

Methods: Adult (≥18 years) hemodialysis patients were included. Data on medication regimen complexity index (MRCI), self-reported and objective adherence, comorbidity index, PBM and HR-QoL were obtained using established measures. Sociodemographic and clinical characteristics were collected during interviews and by reviewing medical records. Predictors of adherence were determined using logistic regression.

Results: Fifty-three out of 70 hemodialysis patients participated (response rate 75%; male 58.5%; age 67.9 11.5 years). The mean MRCI, HR-QoL and PBM scores were 27.0 10.9, 0.70 0.13 and 1.7 0.6, respectively. Based on self-reports, 43.4% (n = 23) were adherent, whereas for a subset of patients analyzed using objective measure (n = 33), much lower adherence rate was observed (27.3%, n = 9). The self-reported and objective measures were significantly correlated (r = 0.43, p = 0.01). Older age was the only significant predictor of self-reported adherence (OR 1.05; 95% CI 1.00-1.11) whereas older age (OR 1.10; 95% CI 1.00-1.21), higher comorbidity (OR 1.58; 95% CI 1.03-2.42) and MRCI (OR 1.14; 95% CI 1.02-1.27) were independent predictors of objective adherence.

Conclusions: The findings of this exploratory study suggest that older patients with high comorbidities and highly complex regimen are more likely to be adherent based on an objective measure. Future research is needed using objective measures of adherence suitable for all patients and reflecting all medications.

Item Details

Item Type:Refereed Article
Keywords:adherence, haemodialysis, health-related quality of life, kidney failure, chronic, medication regimen complexity, perceived burden of medicines,dialysis, chronic kidney disease, end-stage kidney disease, medication adherence, regimen complexity
Research Division:Biomedical and Clinical Sciences
Research Group:Pharmacology and pharmaceutical sciences
Research Field:Clinical pharmacy and pharmacy practice
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health outcomes
UTAS Author:Ghimire, S (Mr Saurav Ghimire)
UTAS Author:Peterson, GM (Professor Gregory Peterson)
UTAS Author:Castelino, RL (Dr Ronald Castelino)
UTAS Author:Jose, MD (Professor Matthew Jose)
UTAS Author:Zaidi, STR (Dr Tabish Razi Zaidi)
ID Code:109092
Year Published:2016
Web of Science® Times Cited:17
Deposited By:Pharmacy
Deposited On:2016-05-20
Last Modified:2017-11-02

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