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Medication adherence perspectives in haemodialysis patients: a qualitative study


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Ghimire, S ORCID: 0000-0002-2538-9433, Castelino, RL, Jose, MD ORCID: 0000-0002-9589-0071 and Razi Zaidi, ST ORCID: 0000-0002-2031-1055 2017 , 'Medication adherence perspectives in haemodialysis patients: a qualitative study' , BMC nephrology, vol. 18, no. 1 , pp. 1-9 , doi: 10.1186/s12882-017-0583-9.

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Background: End-stage kidney disease patients undergoing haemodialysis are prescribed with multiple complexregimens and are predisposed to high risk of medication nonadherence. The aims of this study were to explorefactors associated with medication adherence, and, to examine the differential perspectives on medication-takingbehaviour shown by adherent and nonadherent haemodialysis patients.Methods: A qualitative exploratory design was used. One-on-one semi-structured interviews were conducted with30 haemodialysis patients at the outpatient dialysis facility in Hobart, Australia. Patient self-reported adherence wasmeasured using 4-item Morisky Green Levine scale. Interview transcripts were thematically analysed and mappedagainst the World Health Organization (WHO) determinants of medication adherence.Results: Participants were 44–84 years old, and were prescribed with 4–19 medications daily. More than half of theparticipants were nonadherent to their medications based on self-reported measure (56.7%, n = 17). Themes mappedagainst WHO adherence model comprised of patient-related (knowledge, awareness, attitude, self-efficacy, action control,and facilitation); health system/ healthcare team related (quality of interaction, and mistrust and collateral arrangements);therapy-related (physical characteristics of medicines, packaging, and side effects); condition-related (symptom severity);and social/ economic factors (access to medicines, and relative affordability).Conclusions: Patients expressed a number of concerns that led to nonadherence behaviour. Many of the issuesidentified were patient-related and potentially modifiable by using psycho-educational or cognitive-behaviouralinterventions. Healthcare professionals should be more vigilant towards identifying these concerns to addressadherence issues. Future research should be aimed at understanding healthcare professionals’ perceptions andpractices of assessing medication adherence in dialysis patients that may guide intervention to resolve thissignificant issue of medication nonadherence.

Item Type: Article
Authors/Creators:Ghimire, S and Castelino, RL and Jose, MD and Razi Zaidi, ST
Keywords: Medication, adherence, haemodialysis
Journal or Publication Title: BMC nephrology
Publisher: BioMed Central
ISSN: 1471-2369
DOI / ID Number: 10.1186/s12882-017-0583-9
Copyright Information:

Copyright 2017 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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