Evaluation of polypharmacy and adherence to the phosphorus binding treatment in hemodialysis patients

Evaluation of polypharmacy and adherence in hemodialysis patients

Abstract

Background: Polypharmacy and nonadherence to treatment regimens confront as an ever-mounting problem in hemodialysis patients. The aim of the present study was to emphasize the importance of polypharmacy and tablet load problem and to evaluate the adherence to phosphorus binding agent treatment and to examine the factors that cause to non-adherence.

Material and Method: 361 patients who were in regular dialysis program in 4 different hemodialysis centers in Samsun city were included in the study. By meeting face to face, a questionnaire that was composed of 35 questions which investigated the factors that effect the polypharmacy and treatment adherence was filled to patients by a physician. Adherence to phosphorus binding treatment was measured according to both serum phosphorus level and Modified Morisky Adherence Scale.

 Results: In hemodialysis patients, the mean daily used drug groups were found as 5, the tablet count was found as 10. It was determined that the phosphorus levels of % 40.4 of patients who were using phosphorus binding agents were found above the target phosphorus level that was recommended in the guidelines. According to the adherence questionnaire that was performed to the patients, non-adherence rate to the phosphorus binding agents was found 77,3 %. In addition, age, educational background, smoking and tablet load are the factors that were not found effective on the adherence to the phosphorus binding agents treatment .

Conclusion: Polypharmacy and non-adherence to the phosphorus binding treatment are serious and worth-stressing problems that should be solved in hemodialysis patients. We think that more, more advanced and quality research is needed to improve adherence on this subject