A modified version of the Greek Simplified Medication Adherence Questionnaire for hemodialysis patients

Abstract

Non-adherence to the therapeutic regimen is an increasingly growing problem especially among patients undergoing hemodialysis. The aim of this study was to modify the Greek version of Simplified Medication Adherence Questionnaire (GR-SMAQ) for patients undergoing hemodialysis (GR-SMAQ-HD) and explore its validity and reliability. Between June 2016 and November 2016 a group of patients undergoing hemodialysis (N=107) completed the Greek version of SMAQ. The study was carried out in three Dialysis Units of Hospitals of Athens and Peloponnese region, Greece. The form of GR-SMAQ was modified specifically for renal patients while four additional items were added so as the tool study all aspects of adherence to hemodialysis regimen. Construct validity was checked through exploratory factor analysis with principal Component Analysis with the Equamax method. Test-retest reliability and internal consistency were tested. Statistical analysis was performed using the IBM SPSS Statistics version 21. The significance level was set up at 5%. The Greek version of SMAQ for patients undergoing hemodialysis includes eight questions. Three factors emerged from factor analysis. Cronbach’s a coefficient was 0.742 for the whole scale and for each subscale was for Medication Adherence 0.75, for Attendance at hemodialysis session 0.856 and for Diet/Fluid restriction was 0.717. The total mean score was 6.29 (±1.82). GR-SMAQ-HD is a reliable and valuable tool that can be used by hemodialysis nurses and students of nursing for detection of adherence levels in clinical practice.

Impact of Adverse Drug Reactions in Patients with End Stage Renal Disease in Greece

“…The 60 ESRD patients that were included in the current study had similar characteristics in terms of demographic, dry weight, and lifestyle habits, with data available from previous studies [23,[31][32][33].…”

“…The complexity of medication regiments and the high number of drugs that are administered in ESRD patients can also lead to the appearance of drug-drug interactions (DDIs) that can be the pharmacological underlying reason for ADRs [18,19]. Overall, the presence of ADRs in ESRD patients can be related to impaired quality of life, possible hospital re-admissions in case of life-threatening ADRs, poor adherence and compliance and increased healthcare costs [14,[20][21][22][23][24].…”

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“…Three of the items are dichotomous (Yes/No) while five are scored on a 5 point Likert-type scale. The internal consistency of the scale has been studied (Cronbach's Alpha 0.751) [24]. The score ranges from 0-8.…”

“…GR-SMAQ-HD is the modified version of GR-SMAQ [24] which has been translated in Greek language and culturally adapted for Greek lung cancer patients [38]. The first version of SMAQ was used to measure adherence levels on the dimension of medication among HIV patients [39].…”

Adherence to Management in Patients With End Stage Renal Disease

“…Given the requirement of clinging to so many things, it becomes difficult for patients to comply with physicians' instructions in the long run. We also know that poor compliance to management would add to the morbidity and mortality 4 .…”