Aims: This study aims to identify differences in outcomes of assessing overall versus individual adherence and factors associated with adherence to medication therapy in chronic kidney disease patients. Study Design:  This is a cross-sectional study. Place and Duration of Study: Nephrology Clinic, Universiti Kebangsaan Malaysia Medical Centre and Ministry of Health Hospitals between June 2018 and June 2019. Methodology: We included 491 patients (243 men, 248 women); average age of 54.5 (±14.6) years with chronic kidney disease and prescribed at least one medication, using a validated questionnaire. Results: Patients were prescribed an average of 7.0±2.4 medications. Majority were categorized as adherent (n=404, 82.3%) based on an overall assessment. In contrast, only 27.5% (n=135) were adherent when medications were assessed individually. Based on individual medication assessment, a multivariate logistic regression demonstrated patients aged >55 years were 2.3 times more likely to be adherent toward medicines (P=.001). Those with <3 comorbidities and <7 medications increased the odds of adherence by 2.1 (P=.002) and 2.2 (P=.001) times respectively. Having a drug knowledge score >80% increase the odds of adherence by 8.7 times compared to their counterparts (P<.01). Conclusion: Potential strategies for targeted management should be developed in order to remove barriers towards medication adherence in chronic kidney disease patients.

Pharmacist's interventions in anaemia management have been shown to improve clinical and economic outcomes. To determine the outcome of hemoglobin (Hb) level after the implementation of ESA monitoring card and counselling, a prospective, single-blinded randomised controlled study involved patients attending the CAPD clinic in Terengganu tertiary hospital, Malaysia was carried out. Intervention group received ESA injection counselling based on a validated checklist and ESA monitoring card, while the standard care group only received standard care. Result showed a total of 118 eligible patients with 68 of them in the standard care group and 50 patients in the intervention group with an average age of 50.8 (±14.57) and 49.4 (±13.69) years, respectively. Mean Hb showed significant improvement in both standard care and interventional groups with p<0.001. Intervention group had a higher percentage increment in mean Hb 6.7% compared to standard care group 5.9%. However, mean difference Hb between standard care and interventional group after at least 1 month of interventions was not significant with 0.59 (±1.78) and 0.692 (±1.68) respectively (p=0.764). In conclusion, pharmacist's interventions, including counselling and ESA monitoring card may help in improving Hb level in CAPD patients.

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