Survey finds barriers to treatment adherence among patients on dialysis

A nationwide survey conducted by the American Kidney Fund revealed patients aged 18 to 39 years are more likely to struggle with their prescribed treatment regimen for kidney failure than older patients.

According to a press release from the AKF, depression emerged as a leading contributing factor to treatment nonadherence across all age groups; however, younger patients reported feeling depressed nearly twice as often as older patients.

“I think the most interesting finding is the strong association between patient's mental state and adherence. We see that depression that is associated with a two-fold increase in nonadherence,” Daniel Cukor, PhD, an associate professor of psychiatry at SUNY Downstate Medical Center who did not conduct the survey, told Healio Nephrology. “Also, we see a connection between how strongly people feel the behavior is needed for their health and how adherent they are with that behavior. This makes perfect sense, if you don’t appreciate the value of your particular medication, you may find yourself ‘forgetting’ a lot more frequently than if you believed it was lifesaving.”

Highlights from the survey included the following:

Almost one-third of patients reported leaving their dialysis sessions early – 18% said they skipped sessions entirely.
Among patients aged 18 to 39 years, half left sessions early and 30% skipped sessions. Nonadherence to medication regime was reported at a higher rate in this group (38%) than for the older patients. Younger patients were also less likely to adhere to their prescribed diets (71%).
Overall, 42% of patients reported depression, nervousness or fear stopped them from doing activities they wanted or needed to complete in the last month.
Patients aged 18 to 39 years reported higher rates of feelings of sadness (36%) than any other age group.
Patients who reported that they experienced depression twice a month or more were more likely (28%) to skip dialysis sessions than those who reported never feeling depressed. Patients who felt depressed at least once a month also skipped medication at higher rates (30%).

Nonadherence to treatment can lead to hospitalizations, adverse health effects and even death. This survey could help identify how widespread nonadherence is among dialysis patients, the factors that hinder patients’ ability to adhere to treatment plans and interventions that could help the self-management of patients, according to the release.

“The treatment regimen for people living with kidney failure is complex and demanding, yet following the prescribed treatment plan is essential for patients to have the best health outcomes possible,” LaVarne A. Burton, president and CEO of the AKF, said in the release. “Living with kidney failure is enormously challenging for patients, and we want this survey to foster a deeper understanding of patient experiences and challenges so that the entire renal community may more effectively support patients.” - by Jake Scott

References:

www.kidneyfund.org/adherence

www.kidneyfund.org/news/news-releases/akf-adherence-report

Disclosures: This survey was funded by a grant from Amgen. No other relevant financial disclosures were reported.