Saurav Ghimire|Ronald L. Castelino|Nicole Lioufas|Gregory M. Peterson|Syed Tabish R. Zaidi
Nonadherence to Medication Therapy in Haemodialysis Patients: A Systematic Review
University of Tasmania|University of Tasmania|Royal Hobart Hospital|University of Tasmania|University of Tasmania
background endstage kidney disease eskd patients often prescribed multiple medications together demanding weekly schedule dialysis sessions increased number medicines associated regimen complexity predispose high risk medication nonadherence review summarizes existing literature nonadherence identifies factors associated nonadherence medication therapy patients undergoing haemodialysis methods comprehensive search pubmed embase cinahl psycinfo cochrane database systematic reviews covering period 1970 november 2014 performed following predefined inclusion exclusion criteria reference lists relevant materials reviewed data study characteristics measures nonadherence prevalence rates factors associated nonadherence collected preferred reporting items systematic reviews metaanalyses prisma guidelines followed conducting systematic review results 920 relevant publications 44 included prevalence medication nonadherence varied 125 986 widespread heterogeneity measures definitions employed common patientrelated factors significantly associated nonadherence younger age noncaucasian ethnicity illness interfering family life smoker living single divorced widowed similarly diseaserelated factors include longevity haemodialysis recurrent hospitalization depressive symptoms concomitant illness like diabetes hypertension medicationrelated factors daily tablet count total pill burden number phosphate binders prescribed complexity medication regimen also associated poor adherence conclusions number patient disease medicationrelated factors associated medication nonadherence haemodialysis patients clinicians aware factors adherence medications optimised haemodialysis patients future research directed towards welldesigned prospective longitudinal studies developing standard definitions validating available measurement tools focusing role additional factors psychosocial behavioural factors predicting nonadherence medications