Predictors of nonadherence with blood pressure regimens in hemodialysis

BACKGROUND: Hypertension is very poorly controlled in patients on hemodialysis (HD). Demographic and psychosocial predictors of nonadherence with blood pressure (BP) regimens in HD have not been investigated. A study of 118 HD patients from six outpatient HD units was conducted to determine the relationship between demographic/psychosocial factors and adherence with BP-related regimens, ie, fluid restriction, BP medication adherence, and HD treatment adherence. METHODS: Descriptive statistics, Pearson correlations, and multiple regressions were conducted to analyze and determine the relationships between variables. RESULTS: Younger age was related to increased fluid gains (r = −0.37, P < 0.01), decreased medication adherence (r = −0.19, P = 0.04), increased missed HD treatments (r = −0.37, P < 0.01), and diastolic BP (r = −0.60, P < 0.01). Female sex was significantly related to decreased fluid gains (r = −0.28, P < 0.01). Race was related to increased missed HD treatments (r = 0.22, P = 0.02). Increased social support was related to decreased missed HD treatments (r = −0.22, P = 0.02). Depression scores were inversely related to decreased medication adherence scores (r = 0.24, P = 0.01). CONCLUSION: By identifying risk factors for nonadherence with BP-related regimens (young age, male sex, decreased social support, and depression), health care providers can plan early clinical intervention to minimize the risk of nonadherence.