An International Study of Patient Compliance With Hemodialysis

Bleyer, Anthony J.; Hylander, Britta; Sudo, Hiroshi; Nomoto, Yasuo; Torre, Ernesto de la; Chen, Randolph A.; Burkart, John M.

doi:10.1001/jama.281.13.1211

Cited by 72 publications

(63 citation statements)

References 6 publications

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“…Several studies have shown that dialysis-dependent patients are at an especially elevated risk of medication-related problems, medication discrepancies, and drug-record discrepancies. 3,4,6,7,15,16,[20][21][22][23] In the current 2-year study, the mean number of medication discrepancies identified through ambulatory medication reconciliation was 1.31 per hemodialysis patient and 0.65 per reconciliation process. A previous study reported drug record discrepancies of 1.7 (SD 1.3) per patient when information gathered from the patient was compared with information in an electronic medical record.…”

Section: Discussionmentioning

confidence: 96%

Ambulatory Medication Reconciliation in Dialysis Patients: Benefits and Community Practitioners’ Perspectives

Wilson

Ladda

Tran

et al. 2017

CJHP

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Background: Ambulatory medication reconciliation can reduce the frequency of medication discrepancies and may also reduce adverse drug events. Patients receiving dialysis are at high risk for medication discrepancies because they typically have multiple comorbid conditions, are taking many medications, and are receiving care from many practitioners. Little is known about the potential benefits of ambulatory medication reconciliation for these patients. Objectives: To determine the number, type, and potential level of harm associated with medication discrepancies identified through ambulatory medication reconciliation and to ascertain the views of community pharmacists and family physicians about this service. Methods: This retrospective cohort study involved patients initiating hemodialysis who received ambulatory medication reconciliation in a hospital renal program over the period July 2014 to July 2016. Discrepancies identified on the medication reconciliation forms for study patients were extracted and categorized by discrepancy type and potential level of harm. The level of harm was determined independently by a pharmacist and a nurse practitioner using a defined scoring system. In the event of disagreement, a nephrologist determined the final score. Surveys were sent to 52 community pharmacists and 44 family physicians involved in the care of study patients to collect their opinions and perspectives on ambulatory medication reconciliation. Results: Ambulatory medication reconciliation was conducted 296 times for a total of 147 hemodialysis patients. The mean number of discrepancies identified per patient was 1.31 (standard deviation 2.00). Overall, 30% of these discrepancies were deemed to have the potential to cause moderate to severe patient discomfort or clinical deterioration. Survey results indicated that community practitioners found ambulatory medication reconciliation valuable for providing quality care to dialysis patients. Conclusions: This study has provided evidence that ambulatory medication reconciliation can increase patient safety and potentially prevent adverse events associated with medication discrepancies.

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Section: Discussionmentioning

confidence: 96%

Ambulatory Medication Reconciliation in Dialysis Patients: Benefits and Community Practitioners’ Perspectives

Wilson

Ladda

Tran

et al. 2017

CJHP

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“…The perception of urban, black hemodialysis patients regarding physician attitudes is linked with regimen adherence, 28 which in turn predicts survival. 21,22,29 Alternatively, physician practice, training, and quality may vary between locales. Differences in social support, 21,22,24 availability of prescription drugs, 30 or distribution of income between states or nations 5 may play roles in underpinning differential mortality outcomes.…”

Section: Discussionmentioning

confidence: 99%

Segregation, Income Disparities, and Survival in Hemodialysis Patients

Kimmel

Fwu

Eggers

2013

Journal of the American Society of Nephrology

101

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“…This explanation, however, does not fully explain the observed differences, because two of our own studies of Belgian heart (48) and Dutch liver transplant patients (49) used a similar data-cleaning protocol but still found taking (48) and dosing (49) adherence prevalences that were lower than those measured in this study (median for both parameters was 99%). Fourth, another possible source of non-adherence prevalence variation is regional differences among the study samples, which is supported by a recent meta-analysis of individual patient data (50) that pooled self-reported non-adherence data of North American (15) and European patients (33,45), and by nonadherence research in non-transplant populations (51,52). Data from these studies share a geographical pattern similar to the one we observed: patients in the United States displayed the highest non-adherence, whereas those in…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Risk Factors of Non-Adherence with Immunosuppressive Medication in Kidney Transplant Patients

Denhaerynck

Steiger

Böck

et al. 2007

American Journal of Transplantation

172

171

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Non-adherence with immunosuppressive regimen is a major risk factor for poor outcome after kidney transplantation. Identifying patients at risk for nonadherence requires understanding the risk factors for non-adherence. This prospective study included a convenience sample of 249 adult kidney transplant patients >1 year post-transplant. Non-adherence was monitored electronically using MEMS®. Selected socio-economic, therapy-, patient-, condition-and healthcare team-related risk factors for non-adherence were assessed. Period prevalences were expressed as the percent of prescribed doses taken (taking adherence), the percent of correctly dosed days (dosing adherence), the percentage of inter-dose intervals not exceeding 25% of the prescribed interval (timing adherence), and the number of drug holidays per 100 days (no intake for > 48 h if once daily or for > 24 h if twice daily intake). Testing occurred by simple mixed logistic regression analysis. Factors significant after correction for multiple testing were entered into a multiple logistic regression model. Mean taking, dosing, timing adherence, and drug holidays were 98%, 96%, 93%, and 1.1 days, respectively. Non-adherence was associated with lower self-efficacy, higher self-reported nonadherence, no pillbox usage, and male gender. Adherence declined between Monday and Sunday. This study provides a framework for identifying patients at risk for non-adherence and for developing adherenceenhancing interventions.

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An International Study of Patient Compliance With Hemodialysis

Cited by 72 publications

References 6 publications

Ambulatory Medication Reconciliation in Dialysis Patients: Benefits and Community Practitioners’ Perspectives

Ambulatory Medication Reconciliation in Dialysis Patients: Benefits and Community Practitioners’ Perspectives

Segregation, Income Disparities, and Survival in Hemodialysis Patients

Prevalence and Risk Factors of Non-Adherence with Immunosuppressive Medication in Kidney Transplant Patients

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