Non-adherence, medication beliefs and symptom burden among patients receiving hemodialysis -a cross-sectional study

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Non-adherence to medication is a common and complex issue faced by individuals undergoing hemodialysis (HD). However, more knowledge is needed about modifiable factors influence on non-adherence. This study investigated the prevalence of non-adherence, medication beliefs and symptom burden and severity among patients receiving HD in Denmark. Associations between non-adherence, medications beliefs and symptom burden and severity were also explored.

A cross-sectional questionnaire-based multisite study, including 385 participants. We involved patient research consultants in the study design process and the following instruments were included: Medication Adherence Report Scale, Beliefs about Medication Questionnaire and Dialysis Symptom Index. Logistic regression analysis was performed.

The prevalence of non-adherence was 32% (95% CI 27–37%) using a 23-point-cut-off. Just over one third reported being concerned about medication One third also believed physicians to overprescribe medication, which was associated with 18% increased odds of non-adherence. Symptom burden and severity were high, with the most common symptoms being tiredness/ lack of energy, itching, dry mouth, trouble sleeping and difficulties concentrating. A high symptom burden and/or symptom severity score was associated with an increased odd of non-adherence.

The study found significant associations between non-adherence and, beliefs about overuse, symptom burden and symptom severity. Our results suggest health care professionals (HCP) should prioritize discussion about medication adherence with patients with focus on addressing patient-HCP relationship, and patients’ symptom experience. Future research is recommended to explore the effects of systematically using validated adherence measures in clinical practice on medication adherence, patient-HCP communication and trust. Additionally, studies are warranted to further investigate the relationship between symptom experience and adherence in this population.

Trial registration
TidsskriftBMC Nephrology
Udgave nummer1
Antal sider10
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
Open access funding provided by Royal Library, Copenhagen University Library Research reported in this article was funded through the Novo Nordisk Foundation (NNF17OC0029778) (NNF18OC0052951). The views presented are solely the responsibility of the author(s) and do not necessarily represent the views of the Novo Nordisk Foundation.

Funding Information:
The authors would like to acknowledge the patient research consultants for their valuable contributions in conducting this study and University Hospital Rigshospitalet, University Hospital Herlev and University Hospital Hillerød for their valuable help with recruiting patients. Thank you also to Ingrid Egerod RN, PhD, Professor Emerita Faculty of Health and Medical Sciences, University of Copenhagen. Copenhagen, Denmark and Mary Jarden RN, PhD, Professor, Head of Research Nursing at Center for Cancer and Organ Diseases, Copenhagen University Hospital—Rigshospitalet. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen. Copenhagen, Denmark for their valuable contributions regarding translation in our study.

Publisher Copyright:
© 2023, The Author(s).

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