A Study on Medication Adherence and Quality of Life in Patients with Chronic Kidney Disease
Back ground: Chronic Kidney Disease (CKD) is the most common health related problem. Poor long term adherence is the major clinical issue in the management of CKD. Therefore good medication adherence is important to obtain desired therapeutic outcome which in turn improves the quality of life of the patient. The aim of the study is to carry out a study on medication adherence and to improve health related quality of life in patients with CKD.
Objectives: To evaluate medication adherence and to assess the factors associated with non adherence and to provide patient counselling to improve medication adherence and to improve their quality of life.
Methods: A prospective study conducted for a period of six months in NU Hospitals Bengaluru. A total of 140 patients (62 were undergoing hemodialysis, 66 were CKD stage 3-5 and 12 were post-transplant patients) were enrolled for the study. Patient’s adherence to medication was assessed with the help of Modified Morisky, Green, Levine Medication Adherence Scale and Quality of life was assessed with the help of Kidney Disease Quality of Life-Short Form 36 questionnaire. One to one follow up was done after 3 months of initial data collection.
Results: During the study 140 patients were enrolled for the study with 103 males and 37 females. Patient with low and medium adherence during the first visit were 7 (5%) and 21 (45%) respectively and patients with high adherence during baseline visit were 80%, which later improved to 85.7% in the final review after patient counselling. Quality of life is decreased in patients with CKD. The domain with highest average score was emotional well being (8.4) and lowest average score was role limitation due to physical health (4.12). There was a slight improvement in Quality of Life of the patients after patient counselling.
Conclusion: Study suggests that patient counselling by clinical pharmacists can improve the medication adherence by improving awareness about medication which in turn helps them to achieve a better quality of life.
2. Dasari P, Venkateshwarlu K, Venisetty R. Management of comorbidities in chronic kidney disease: a prospective observational study. Int J Pharm Pharm Sci 2014; 6(2):363-7.
3. Kramer H, Berns JS, Nally J, Choi MJ, Rocco MV. A decade after the KDOQI CKD guidelines: impact on NKF-KDOQI. American Journal of Kidney Diseases 2012; 60(5):694-6.
4. Firdous SS, Siddiqua A, Navaneetha K, Srujana P. Assessment of risk factors and medication adherence of chronic kidney disease patients in a tertiary care teaching hospital 2014; 2:6.
5. Alves KB, Guilarducci NV, Santos TD, Baldoni AO, Otoni A, Pinto SW, Zanette C, Sanches C. Is quality of life associated with compliance to pharmacotherapy in patients with chronic kidney disease undergoing maintenance hemodialysis? 2018; 16(1).
6. Siva Kala T, Arepalli Sreedevi, Hari Prasad MV, Jikki PN. Assessment of knowledge and adherence to therapy among chronic kidney disease patients attending nephrology department of tertiary care hospital, Kurnool city, Andhra Pradesh. International Journal of Medical Science and Public Health 2019; 8(3):223-9.
7. Fasipe OJ, Akhideno PE, Ibiyemi-Fasipe OB, Idowu AA. The burden of polypharmacy and pattern of comorbidities among chronic kidney disease patients in clinical practice. Archives of Medicine and Health Sciences 2018; 6(1):40.
8. Tesfaye W, Castelino RL, Wimmer BC, Mckercher C, Jose MD, Peterson GM, Zaidi ST. Medication adherence in adults with advanced chronic kidney disease. In nephrology 2018; 25:44-45.
9. Chan YM, Zalilah MS, Hii SZ. Determinants of compliance behaviours among patients undergoing hemodialysis in Malaysia. PLoS One 2012; 7(8):e41362.
10. Ahlawat R, Tiwari P, D'Cruz S. Prevalence and predictors of medication non-adherence in patients of chronic kidney disease: Evidence from a cross sectional study. J Pharma Care Health Sys 2016; 3(152):2376-419.
11. Tangkiatkumjai M, Walker DM, Praditpornsilpa K, Boardman H. Association between medication adherence and clinical outcomes in patients with chronic kidney disease: a prospective cohort study. Clinical and experimental nephrology 2017; 21(3):504-12.
12. Verma B, Singh A, Bishnoi JS, Mishra AK. Adherence to Medications in Chronic Kidney Disease: Prevalence, Predictors and Outcomes. Int J Cur Res Rev 2018; 10(19):14.
13. Chiu YW, Teitelbaum I, Misra M, De Leon EM, Adzize T, Mehrotra R. Pill burden, adherence, hyperphosphatemia, and quality of life in maintenance dialysis patients. Clinical Journal of the American Society of Nephrology 2009; 4(6):1089-96.
14. Ghimirey A, Sapkota B, Shrestha S, Basnet N, Shankar PR, Sapkota S. Evaluation of pharmacist counseling in improving knowledge, attitude, and practice in chronic kidney disease patients. SAGE open medicine 2013; 1(12):1-5.
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