Medication Adherence, Burden and Health-Related Quality of Life in Adults with Predialysis Chronic Kidney Disease: A Prospective Cohort Study.

Autor: Tesfaye WH; Pharmacy, School of Medicine, College of Health and Medicine, University of Tasmania, Hobart 7005, Tasmania, Australia., McKercher C; Menzies Institute for Medical Research, Hobart 7000, Tasmania, Australia., Peterson GM; Pharmacy, School of Medicine, College of Health and Medicine, University of Tasmania, Hobart 7005, Tasmania, Australia., Castelino RL; Sydney Nursing School, The University of Sydney, Sydney 2006, New South Wales, Australia., Jose M; Sydney Nursing School, The University of Sydney, Sydney 2006, New South Wales, Australia.; Royal Hobart Hospital, Hobart 7000, Tasmania, Australia., Zaidi STR; School of Healthcare, University of Leeds, Leeds LS2 9JT, UK., Wimmer BC; Pharmacy, School of Medicine, College of Health and Medicine, University of Tasmania, Hobart 7005, Tasmania, Australia.
Jazyk: angličtina
Zdroj: International journal of environmental research and public health [Int J Environ Res Public Health] 2020 Jan 06; Vol. 17 (1). Date of Electronic Publication: 2020 Jan 06.
DOI: 10.3390/ijerph17010371
Abstrakt: This study examines the associations between medication adherence and burden, and health-related quality of life (HRQOL) in predialysis chronic kidney disease (CKD). A prospective study targeting adults with advanced CKD (estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m 2 ) and not receiving renal replacement therapy was conducted in Tasmania, Australia. The actual medication burden was assessed using the 65-item Medication Regimen Complexity Index, whereas perceived burden was self-reported using a brief validated questionnaire. Medication adherence was assessed using a four-item Morisky-Green-Levine Scale (MGLS) and the Tool for Adherence Behaviour Screening (TABS). The Kidney Disease and Quality of Life Short-Form was used to assess HRQOL. Of 464 eligible adults, 101 participated in the baseline interview and 63 completed a follow-up interview at around 14 months. Participants were predominantly men (67%), with a mean age of 72 (SD 11) years and eGFR of 21 (SD 6) mL/min/1.73 m 2 . Overall, 43% and 60% of participants reported medication nonadherence based on MGLS and TABS, respectively. Higher perceived medication burden and desire for decision-making were associated with nonadherent behaviour. Poorer HRQOL was associated with higher regimen complexity, whereas nonadherence was associated with a decline in physical HRQOL over time. Medication nonadherence, driven by perceived medication burden, was prevalent in this cohort, and was associated with a decline in physical HRQOL over time.
Databáze: MEDLINE