Evaluation of medication adherence and predictors of sub-optimal adherence among pre-dialysis patients with chronic kidney disease

Abstract

Background: Multiple medications are required to effectively manage chronic kidney disease (CKD) and associated complications, posing the risk of poor medication adherence. Objectives: To measure medication adherence levels and to investigate the potential predictors of sub-optimal medication adherence in pre-dialysis patients with CKD. Methods: A prospective study was conducted in the medical and nephrology outpatients’ clinics in Maiduguri. Non-dialysis patients with CKD stages 1–4 aged 18 years and above were recruited through their physicians. The level of medication adherence was determined using Morisky Medication Adherence Scale. Descriptive statistics were used to summarize patients’ background characteristics. Multivariate binary logistic regression analyses were performed to investigate the significantly potential predictors of sub-optimal medication adherence at a p < 0.05. Results: There were 107 participants (48.6%) who had high medication adherence, while 97 (44.1%), and 16 (7.3%) of them had moderate adherence, and low adherence, respectively. The univariate analysis revealed that medication adherence level differed significantly with the number of medications taken daily by patients ( p < 0.05). Multivariate logistic regression analyses did not reveal a significant independent predictor of sub-optimal medication adherence. Conclusion: A majority of the participants reported sub-optimal medication adherence. The independent variables considered did not significantly predict sub-optimal medication adherence in the study population. Nevertheless, the study findings highlight the importance of clinical pharmacists’ CKD management supportive care to help improve medication adherence.

Patient activation in advanced chronic kidney disease: a cross-sectional study

“…Medication adherence was linear until a patient activation score of 51 (when patient activation scores change from low activation to high activation), then it plateaued. This is an important finding given that patient outcomes in CKD depend on patients taking their medicines in line with their prescribed regimen to yield the full benefit of the treatment [ 31 ]. Non-adherence to medication is costly for the healthcare service, both through waste and increased ill health [ 31 ].…”

“…This is an important finding given that patient outcomes in CKD depend on patients taking their medicines in line with their prescribed regimen to yield the full benefit of the treatment [ 31 ]. Non-adherence to medication is costly for the healthcare service, both through waste and increased ill health [ 31 ]. High levels of medication adherence have long been identified as a crucial factor in reducing the progression from advanced kidney failure to dialysis start and/or increasing life expectancy in those who choose not to have dialysis [ 32 ].…”