Adherence to Medications in Chronic Kidney Disease: Prevalence, Predictors and Outcomes
Journal Title: International Journal of Current Research and Review - Year 2018, Vol 10, Issue 19
Abstract
Background: In India there is scarcity of studies regarding medication non-adherence in CKD (chronic kidney disease) patients and there is lack of any prospective data. Objective: To study the prevalence and predictors of medication non-adherence in patients of CKD and outcomes of nonadherence prospectively over 2 years. Material and Methods: In this multi-centric, prospective observational study a total of 510 patients were included after obtaining consent. A validated scale of medication adherence, Morisky 8-item Medication Adherence Scale (MMAS-8) was used to calculate adherence. The primary outcome of the study was all-cause mortality and secondary outcome was composite of all-cause mortality and progression of CKD or occurrence of ESRD (end-stage renal disease). Results: Longitudinal evaluation showed increase in non-adherence over time, from 58% at baseline to 82% at two years. Overall, 18% patients were taking alternative medicines. The rate of all-cause death in low adherence population was numerically double as compared to patients with high adherence (1.4vs 0.7 per 100 patient-years), though the difference was statistically non-significant. The secondary outcome in low adherence population was 5.5 per 100 patient-years compared to 9.9 per 100 patient-years in high adherence population (hazard ratio [HR] = 1.53, 95% confidence interval [CI] = 1.21-1.74). Conclusion: Non adherence to medication is very prevalent among CKD patients in India, which further increases with duration of treatment. High use of alternative medicine was seen without physician’s knowledge, especially in patients on haemodialysis. Moreover, we found that low medication adherence was significantly associated with composite of mortality and disease progression.
Authors and Affiliations
Dr. Bhupendra Verma
Keywords
Related Articles
- EP ID EP536088
- DOI 10.31782/IJCRR.2018.10193
- Views 127
- Downloads 0
Integrated Approach Towards Holistic Health: Current Trends and Future Scope
Modern medicine is evidence based system of medicine with its high end investigative tools, surgical procedures and continued research at molecular, genetic and pharmaceutical levels. Ayurveda is an intricate system of h...
Spectrum of Non-neoplastic Skin Lesions: A Histopathological Study based on Punch Biopsy
Introduction: Accurate diagnosis of skin is of utmost importance for management of different skin disorders presenting with the similar clinical signs and symptoms. Therefore to confirm the diagnosis and start treatment...
Seroepidemiology of Equine Brucellosis and Role of Horse Carcass Processors in Spread of Brucella Infection in Enugu State, Nigeria
Aim: The study was undertaken to obtain baseline data on seroepidemiology of equine brucellosis and role of horse carcass processors in spread of Brucella infection in Enugu State. Materials and Methods: Rose Bengal plat...
Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study
Background: Molar incisor hypomineralization (MIH) describes the clinical picture of hypomineralization of systemic origin affecting one or more first permanent molar and incisors. Although the reported prevalence of MIH...
Study on Blood Donation Among Medical Students of Udaipur City, Rajasthan
Background: This study has been carried out to know the knowledge, attitude and behavior about blood donation among medical college students of Udaipur city. Human blood is an essential element of life and it cannot be s...