eCite Digital Repository

Adherence assessment practices in haemodialysis settings: a qualitative exploration of nurses and pharmacists' perspectives


Ghimire, S and Lee, K and Jose, MD and Castelino, RL and Zaidi, STR, Adherence assessment practices in haemodialysis settings: a qualitative exploration of nurses and pharmacists' perspectives, Journal of Clinical Nursing, 28, (11-12) pp. 2197-2205. ISSN 0962-1067 (2019) [Refereed Article]

Copyright Statement

2019 John Wiley & Sons Ltd

DOI: doi:10.1111/jocn.14821


Aims and objectives: To explore clinician assessment of patient adherence and identify strategies to improve adherence assessment practices in haemodialysis settings.

Background: Patients with chronic kidney disease undergoing haemodialysis are typically prescribed complex regimens; as such, they are at high risk of medication nonadherence. Current clinical practices focus on prescribing medications; however, little attention is paid to measuring and ensuring patient adherence to their prescribed treatments.

Design: A qualitative study. Methods: Semi-structured individual interviews were conducted in November and December 2016, with 12 nurses and 6 pharmacists, working in Australian haemodialysis settings. The study was conducted and reported in accordance with COREQ guidelines.

Results: Participants were 2560 years old and had 127 years of experience in dialysis. Seven themes related to assessing adherence were identified: prioritisation of resources, interplay between workload and available time, awareness of formalised adherence measures and training deficits, concerns about practicality/suitability of adherence measures, communication of assessment services, patient participation and trust. Three themes related to strategies for improving adherence assessment practices were identified: formalisation of adherence assessment process, integration of assessment processes and tools into routine, and use of multidisciplinary support to assess and promote adherence.

Conclusions: Current adherence assessment practices could be improved through formalisation and integration of the assessment process into dialysis unit policy/procedures. Additionally, as barriers to assessing adherence were identified at organisational, professional and patient levels, there is a need to address barriers from each level in order to improve adherence assessment practices in haemodialysis settings.

Relevance to clinical practice: This qualitative study highlights the challenges and practical ways by which adherence assessment practices could be improved in haemodialysis settings. This would encourage renal clinicians to actively participate in adherence assessment and promotion activities to ensure patients benefit from their therapies.

Item Details

Item Type:Refereed Article
Keywords:adherence assessment practices, chronic, dialysis, haemodialysis, kidney failure, medication adherence, qualitative research
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Nephrology and urology
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Ghimire, S (Mr Saurav Ghimire)
UTAS Author:Lee, K (Dr Kenneth Lee)
UTAS Author:Jose, MD (Professor Matthew Jose)
ID Code:133191
Year Published:2019
Web of Science® Times Cited:2
Deposited By:Pharmacy
Deposited On:2019-06-18
Last Modified:2020-08-10

Repository Staff Only: item control page