Patient knowledge and adherence to maintenance hemodialysis: an International comparison study

Miyata, Kana N.; Shen, Jenny I.; Nishio, Yasuhide; Haneda, Manabu; Dadzie, Kobena A.; Sheth, Nijal R.; Kuriyama, Renjiro; Matsuzawa, Chika; Tachibana, Kunihide; Harbord, Nikolas B.; Winchester, James F.

doi:10.1007/s10157-017-1512-8

Cited by 17 publications

(15 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Knowledge scores were not satisfactory at baseline (below the 60% cutoff used) and increased significantly to reach a mean score of 68.1%. It seems that the association between knowledge and dietary nonadherence in dialysis patients is not always clear [ 39 ]. In the results of this prospective pilot, nonadherence to the phosphorus content of the diet increased after the intervention.…”

Section: Discussionmentioning

confidence: 99%

Adequate Management of Phosphorus in Patients Undergoing Hemodialysis Using a Dietary Smartphone App: Prospective Pilot Study

Khoury¹,

Crutzen²,

Schols³

et al. 2021

JMIR Form Res

View full text Add to dashboard Cite

Background The renal diet is complex and requires alterations of the diet and careful monitoring of various nutrients. Elevated serum phosphorus is common among patients undergoing hemodialysis, and it is associated with many complications. Smartphone technology could be used to support both dietitians and patients by providing a source of accessible and reliable information. Objective The aim of this pilot is to assess the potential efficacy of an intervention using the educational and self-monitoring mobile app KELA.AE on the phosphorous management in hemodialysis patients. Results will be used to improve both the app and a planned, rigorous large-scale trial intended to assess app efficacy. Methods This is a prospective pilot study performed at the hemodialysis unit of Al Qassimi Hospital (Emirate of Sharjah, United Arab Emirates). All patients were assessed for eligibility and, based on inclusion criteria, considered for enrollment. Participants met with a dietitian once a week and used the mobile app regularly for 2 weeks. Outcomes (knowledge, self-reported nonadherence, dietary intake, anthropometry, and biochemical data) were measured. This pilot is reported as per guidelines for nonrandomized pilot and feasibility studies and in line with the CONSORT (Consolidated Standards of Reporting Trials) 2010 checklist for reporting pilot or feasibility trials. Results Of 26 subjects, 23 successfully completed the pilot. Patient dietary knowledge about phosphorous management improved from 51.4% (SD 13.9) to 68.1% (SD 13.3) after intervention with a large effect size (d=1.22, 95% CI 0.59 to 1.85). Dietary protein intake increased from a mean of 0.9 g/kg (SD 0.3) per day to a mean of 1.3 g/kg (SD 0.5) per day with a large effect size (d=1.07, 95% CI 0.45 to 1.69). Phosphorus to protein ratio dropped from a mean of 18.4 mg/g protein to 13.5 mg/g protein with a large effect size (d=0.83, 95% CI 0.22 to 1.43). There was no evidence of change in phosphorous intake, self-reported nonadherence, and serum phosphorus. Conclusions The findings of this prospective pilot reveal the potential efficacy of a smartphone app as a supportive nutrition education tool for phosphorus management in patients undergoing hemodialysis. This pilot study showed that the KELA.AE app has the potential to improve knowledge and dietary choices. A rigorous randomized controlled trial should be performed to evaluate the efficacy, assessing app use of a long-term intervention.

show abstract

Section: Discussionmentioning

confidence: 99%

Adequate Management of Phosphorus in Patients Undergoing Hemodialysis Using a Dietary Smartphone App: Prospective Pilot Study

Khoury¹,

Crutzen²,

Schols³

et al. 2021

JMIR Form Res

View full text Add to dashboard Cite

show abstract

“…The proportion of patients knowing their target weight is similar to ndings in US patients 28 and the differences between units re ect international differences. 29 Younger age and higher education have also previously been linked to patients' knowledge of haemodialysis. 30 However, unlike our results, a study of Norwegian patients suggested some patients feel their input into decisions around uid removal on HD is not considered.…”

Section: Discussionmentioning

confidence: 99%

Patient Perspectives of Target Weight Management and Ultrafiltration in Haemodialysis: A Multi-Center Survey

Keane

Glyde

Dasgupta

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Decisions around planned ultrafiltration volumes are the only part of the haemodialysis prescription decided upon at every session. Removing too much fluid or too little is associated with both acute symptoms and long-term outcomes. The degree to which patients engage with or influence decision-making is not clear. We explored patient perspectives of prescribing ultrafiltration volumes, their understanding of the process and engagement with it.Methods: A questionnaire developed for this study was administered to 1077 patients across 10 UK Renal Units. Factor analysis reduced the dataset into factors representing common themes. Relationships between survey results and factors were investigated using regression models. ANCOVA was used to explore differences between Renal Units.Results: Patients generally felt in control of their fluid management and that they were given the final say on planned ultrafiltration volumes. Around half of the respondents reported they take an active role in their treatment. However, respondents were largely unable to relate signs and symptoms to fluid management practice and a third said they would not report common signs and symptoms to clinicians. A fifth of patients reported not to know how ultrafiltration volumes were calculated. Patients responded positively to questions relating to healthcare staff, though with significant variation between units, highlighting differences in perception of care.Conclusions: Despite a lack of formal acknowledgement in fluid management protocols, patients have significant involvement in decisions regarding fluid removal during dialysis. Furthermore, substantial gaps remain in patient knowledge and engagement. Formalizing the role of patients in these decisions, including patient education, may improve prescription and achievement of target weights.

show abstract

“…It has been reported that the rates of non-adherence to oral medications in chronic hemodialysis patients ranged from 3 to 80% (Schmid et al, 2009 ) and that approximately half of hemodialysis patients are non-adherent to medication therapy (Neri et al, 2011 ). However, non-adherence rates have been reported to be lower in Japan than in the U.S. (Miyata et al, 2017 ). The same was found in the present study.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Quality of Life on Medication Compliance Among Dialysis Patients

et al. 2018

View full text Add to dashboard Cite

Dialysis treatment is known to lead to reduced quality of life (QOL) among patients. This decreased QOL is believed to influence medication compliance, although this effect has not yet been clarified. In this study, we investigated whether decreased QOL due to dialysis treatment does in fact influence medication compliance. Participants were 92 patients who self-managed their medication and were receiving dialysis treatment at Secomedic Hospital or Chiba Central Medical Center. We surveyed their age, sex, dialysis period, and medication management situation, and administered the EQ-5D and Kidney Disease Quality of Life Instrument–Short Form. A multiple logistic regression analysis with medication compliance as the dependent variable and QOL as the independent variable was conducted. The recovery rate and effective response rate were both 100%. The results indicated that patients with good sleep QOL (mean or above) had higher odds of medication compliance (odds ratio, 3.36; 95% confidence interval, 1.26–8.96; P = 0.016). Therefore, improving the quality of sleep of dialysis patients might help to improve their medication compliance.

show abstract

Patient knowledge and adherence to maintenance hemodialysis: an International comparison study

Cited by 17 publications

References 14 publications

Adequate Management of Phosphorus in Patients Undergoing Hemodialysis Using a Dietary Smartphone App: Prospective Pilot Study

Adequate Management of Phosphorus in Patients Undergoing Hemodialysis Using a Dietary Smartphone App: Prospective Pilot Study

Patient Perspectives of Target Weight Management and Ultrafiltration in Haemodialysis: A Multi-Center Survey

The Effect of Quality of Life on Medication Compliance Among Dialysis Patients

Contact Info

Product

Resources

About