EVALUATION AND PHARMACIST’S INTERVENTION FOR IMPROVING ADHERENCE AMONG RENAL FAILURE PATIENTS

摘要

Objective: Management of renal disease may include pharmacotherapy, dialysis, life style modifications, organ transplants and immunosuppressive therapy. Lack of adherence and proper perception towards prescribed renal failure treatment is a major contributor to poor outcome. A prospective, open labeled, interventional, pre-post study which included 60 patients with Chronic Renal Failure (CRF) on Hemodialysis (HD) was conducted over a period of 6 months with an objective to evaluate the degree of adherence, perception towards various treatment recommendations and to study the effect of pharmacist’s intervention in improving compliance among patients on HD. Methods: Patients were assessed using the End Stage Renal Disease- Adherence Questionnaire (ESRD-AQ) scored questionnaire, where subjects were evaluated before and after counseling with a follow up period of 45 days and their response was scored. Results: Based on the scored response from 58 subjects who completed the study, overall adherence were grouped into three categories such as good adherence, moderate adherence, poor adherence which at baseline was found to be 69%,24.1%,6.9% of study subjects respectively and was improved to 72.4%,25.9%,1.7% at review. Conclusion: After pharmacist led patient counseling, patient perception towards medications, diet and fluid on showed improvement. On review the data analyzed for adherence parameters were statistically insignificant but clinically comparable with considerable improvement. Common reason cited by study subjects for non-compliance to medications was forgetfulness. From this study it can be concluded that pharmacist’s intervention has a positive impact clinically on patient’s perception and adherence. Keywords : End Stage Renal Disease, Hemodialysis, End Stage Renal Disease – Adherence Questionnaire, Counseling, Adherence, Pharmacist’s Intervention .