<p>Enhancement of Adherence to Therapeutic and Lifestyle Recommendations Among Hemodialysis Patients: An Umbrella Review of Interventional Strategies</p>

Abstract

Objective: To systematically retrieve and condense the best possible evidence on the successful interventions that targeted enhancement of therapeutic and lifestyle recommendations adherence in hemodialysis patients (HDPs). Design: An umbrella review of interventional studies. Data Sources: A comprehensive search of the Cochrane Database of Systematic Reviews, Ovid, PubMed, Scopus, EMBASE and Web of science databases to identify relevant publications in 2000-2018 (June) timeframe. Study Selection: Two reviewers independently applied inclusion criteria to select potential systematic reviews assessing the successful interventions that targeted enhancement of therapeutic and lifestyle recommendations adherence in HDPs. Data were summarized for information about the first author(s)' names, year of publication, type(s) of the intervention and output variables, main findings and also the applied quality appraisal tools in the retrieved research evidence. Data Extraction: Eligible studies were selected and data were extracted independently by two reviewers. The Joanna Briggs Institute (JBI)'s critical appraisal tool for systematic reviews was used to assess the quality of the identified publications, and discrepancies were resolved by consensus with a third reviewer. Data Synthesis: Thirteen systematic reviews (12 solely systematic reviews and 1 systematic review with meta-analyses) were eligible to be enrolled in the study. The range of interventions that had been reported to boost therapeutic and lifestyle recommendations adherence in HDPs' included psycho-educational programs, physical activity enhancement initiatives, information technology (IT)-based interventions and aromatherapy. Depression, diet biomarkers and interdialytic weight gain (IDWG) were among the myriad of output variables that had been measured as proxies to assess impacts of the implemented interventions. Psycho-educational interventions were among the prevalent initiatives to boost therapeutic and lifestyle recommendations adherence among the HDPs. Conclusion: This umbrella review revealed that various intervention approaches and strategies can be used for HDPs' better therapeutic and lifestyle recommendations adherence with considerable methodological heterogeneity. The pinpointed research evidence is also supporting application of multifaceted interventional modalities to reach an improved acquiescence form the patients' side and their families. Further studies are recommended to address the interactions across various interventions in discordant socio-cultural contexts.

The effectiveness of a psychoeducational intervention on health outcomes of patients undergoing haemodialysis: A randomized controlled trial

“…An umbrella review revealed that various intervention approaches and strategies have been used to improve haemodialysis patients' therapeutic and lifestyle recommendation adherence. Psychoeducational interventions have been found to enhance dietary/intake adherence and perceived QoL (Zhianfar, Nadrian, & Shaghaghi, 2020). Psychoeducation often uses cognitive‐behavioural therapy to improve HRQoL and reduces depression and anxiety among haemodialysis patients (Al Saraireh et al, 2018; Ng et al, 2019; Shirazian et al, 2018).…”

“…Psychoeducation often uses cognitive‐behavioural therapy to improve HRQoL and reduces depression and anxiety among haemodialysis patients (Al Saraireh et al, 2018; Ng et al, 2019; Shirazian et al, 2018). However, most intervention studies are outdated and lack explicit explanations of intervention protocols, content, and theory basis (Zhianfar, Nadrian, & Shaghaghi, 2020). Another systematic review had a few studies that used a randomized controlled trial design (Ekuma et al, 2015) or had weaknesses in their randomized controlled trial such as performance (e.g., blinding) and selection bias (e.g., allocation concealment; Ling et al, 2020).…”

“Together We Stand”: A Pilot Study Exploring the Feasibility, Acceptability, and Preliminary Effects of a Family-Based Psychoeducational Intervention for Patients on Hemodialysis and Their Family Caregivers

“…The intervention design was informed by a comprehensive literature review on ESRD [5,[35][36][37][38], evidence on family-based interventions in different chronic conditions [25,26], the researchers' experience, and the results of interviews with HD patients and family caregivers. In fact, there are few systematic data available regarding individuals and families' educational and supportive needs in ESRD.…”

Nutritional Behavior and Medication Adherence among Patients Undergoing Hemodialysis

“…Nonadherence to diet and medication in HDPs can have substantial repercussions, including poor health outcomes and increased morbidity and mortality. 4 Health protection is the science and art of modifying one's lifestyle to achieve perfection. It entails activities such as proper eating, frequent exercise, avoiding harmful habits, and enhancing one's performance despite the disease.…”