Adherence to treatment among chronic kidney disease patients attending selected hemodialysis units of province one, Nepal.

Thesis Report.

ABSTRACT:

Background: Chronic kidney disease (CKD) is progressive, irreversible loss of kidney function. It is a major public health issue that affects people all over the world. Dietary modification, fluid control, proper medications, and renal replacement therapy are all part of comprehensive care for CKD patients. Adherence is a critical tool for achieving the goal of therapy of halting the disease progression and preventing consequences.

Objective: The objective of the study was to assess the treatment adherence among the CKD patients. Methods: A cross-sectional study was conducted among 80 patients attending Hemodialysis units of three centers of Province one. End-Stage Renal Disease Adherence Questionnaire was used to collect data. Interview and record review were used to collect the information on socio demographic data, treatment adherence and clinical measures of non-adherence. Data were analyzed using descriptive and inferential statistical methods.

Results: The mean age of respondents was 49.35±13.81 years. Among the respondents, majority (73.8%) had good and very few (6.2%) had poor level of adherence to treatment of CKD in overal. The percentage of the respondents adhering to dialysis, medicines, diet recommendation and fluid restriction were 87.5%, 80%, 67.5 and 56.2% respectively. The study's findings revealed a significant relationship between adherence to CKD treatment and respondents' ethnicity (p value = 0.011), adherence to CKD treatment with counselling for HD within 1 month (p = 0.02) and counselling for diet (p = 0.01).

Conclusions: Adherence to hemodialysis schedule and medicine was found to be relatively higher than adherence to diet and fluid restriction. Periodic counselling from health professionals could increase patients' adherence to treatment.

Keywords: Adherence, End stage renal disease, Hemodialysis, Treatment.