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Treatment adherence and perception in patients on maintenance hemodialysis: a cross – sectional study from Palestine

BACKGROUND: Adherence to diet recommendations, fluid restriction, prescribed medications, and attendance at hemodialysis (HD) sessions are essential for optimal and effective treatment of patients with end-stage renal disease. No data regarding this issue are available from Palestine. Therefore, thi...

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Autores principales: Naalweh, Karam Sh., Barakat, Mohammad A., Sweileh, Moutaz W., Al-Jabi, Samah W., Sweileh, Waleed M., Zyoud, Sa’ed H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5450383/
https://www.ncbi.nlm.nih.gov/pubmed/28558719
http://dx.doi.org/10.1186/s12882-017-0598-2
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author Naalweh, Karam Sh.
Barakat, Mohammad A.
Sweileh, Moutaz W.
Al-Jabi, Samah W.
Sweileh, Waleed M.
Zyoud, Sa’ed H.
author_facet Naalweh, Karam Sh.
Barakat, Mohammad A.
Sweileh, Moutaz W.
Al-Jabi, Samah W.
Sweileh, Waleed M.
Zyoud, Sa’ed H.
author_sort Naalweh, Karam Sh.
collection PubMed
description BACKGROUND: Adherence to diet recommendations, fluid restriction, prescribed medications, and attendance at hemodialysis (HD) sessions are essential for optimal and effective treatment of patients with end-stage renal disease. No data regarding this issue are available from Palestine. Therefore, this study was carried out to assess adherence to diet, fluid restriction, medications, and HD sessions. METHODS: A cross-sectional study of HD patients at An-Najah National University Hospital was carried out during summer, 2016. Self-reported adherence behavior was obtained using a valid and reliable questionnaire (End-Stage Renal Disease Adherence Questionnaire: ESRD-AQ). Predialytic serum levels of potassium and phosphate were obtained as clinical indicator of diet and medication adherence respectively. In addition, interdialytic body weight (IDW) was also obtained from medical records and analyzed in relation to reported adherence of fluid restriction. RESULTS: A total of 220 patients answered all questions pertaining to ESRD-AQ. The mean age ± standard deviation of participants was 56.82 ± 14.51 years. Dietary adherence was observed in 24% while that of fluid restriction adherence was observed in 31% of studied patients. Reported adherence to HD sessions was 52% while that for medications was 81%. Overall, 122 (55.5%) patients had good adherence, 89 (40.5%) had moderate adherence, and 9 (4.1%) had poor adherence behavior. Male patients had significantly higher overall adherence scores than females (p = 0.034). A significant correlation between reported diet adherence and serum pre-HD potassium level (p < 0.01) was observed. A significant correlation between reported fluid restriction adherence and IDW (p < 0.01) was also found. However, no significant correlation between reported adherence and pre-HD phosphate level. There was significant correlation between overall perception and overall adherence score (p < 0.001). Counselling of patients regarding importance of adherence modalities was lowest for “staying for the entire dialysis time”. Multivariate analysis indicated that elderly male patients who were city residents had higher odds of having higher adherence score. CONCLUSIONS: There was a good percentage of patients who had overall moderate or poor adherence. ESRD-AQ could be used to assess some aspects of HD adherence. Counselling and education of patients on HD are important to improve therapeutic outcome. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12882-017-0598-2) contains supplementary material, which is available to authorized users.
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spelling pubmed-54503832017-06-01 Treatment adherence and perception in patients on maintenance hemodialysis: a cross – sectional study from Palestine Naalweh, Karam Sh. Barakat, Mohammad A. Sweileh, Moutaz W. Al-Jabi, Samah W. Sweileh, Waleed M. Zyoud, Sa’ed H. BMC Nephrol Research Article BACKGROUND: Adherence to diet recommendations, fluid restriction, prescribed medications, and attendance at hemodialysis (HD) sessions are essential for optimal and effective treatment of patients with end-stage renal disease. No data regarding this issue are available from Palestine. Therefore, this study was carried out to assess adherence to diet, fluid restriction, medications, and HD sessions. METHODS: A cross-sectional study of HD patients at An-Najah National University Hospital was carried out during summer, 2016. Self-reported adherence behavior was obtained using a valid and reliable questionnaire (End-Stage Renal Disease Adherence Questionnaire: ESRD-AQ). Predialytic serum levels of potassium and phosphate were obtained as clinical indicator of diet and medication adherence respectively. In addition, interdialytic body weight (IDW) was also obtained from medical records and analyzed in relation to reported adherence of fluid restriction. RESULTS: A total of 220 patients answered all questions pertaining to ESRD-AQ. The mean age ± standard deviation of participants was 56.82 ± 14.51 years. Dietary adherence was observed in 24% while that of fluid restriction adherence was observed in 31% of studied patients. Reported adherence to HD sessions was 52% while that for medications was 81%. Overall, 122 (55.5%) patients had good adherence, 89 (40.5%) had moderate adherence, and 9 (4.1%) had poor adherence behavior. Male patients had significantly higher overall adherence scores than females (p = 0.034). A significant correlation between reported diet adherence and serum pre-HD potassium level (p < 0.01) was observed. A significant correlation between reported fluid restriction adherence and IDW (p < 0.01) was also found. However, no significant correlation between reported adherence and pre-HD phosphate level. There was significant correlation between overall perception and overall adherence score (p < 0.001). Counselling of patients regarding importance of adherence modalities was lowest for “staying for the entire dialysis time”. Multivariate analysis indicated that elderly male patients who were city residents had higher odds of having higher adherence score. CONCLUSIONS: There was a good percentage of patients who had overall moderate or poor adherence. ESRD-AQ could be used to assess some aspects of HD adherence. Counselling and education of patients on HD are important to improve therapeutic outcome. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12882-017-0598-2) contains supplementary material, which is available to authorized users. BioMed Central 2017-05-30 /pmc/articles/PMC5450383/ /pubmed/28558719 http://dx.doi.org/10.1186/s12882-017-0598-2 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Naalweh, Karam Sh.
Barakat, Mohammad A.
Sweileh, Moutaz W.
Al-Jabi, Samah W.
Sweileh, Waleed M.
Zyoud, Sa’ed H.
Treatment adherence and perception in patients on maintenance hemodialysis: a cross – sectional study from Palestine
title Treatment adherence and perception in patients on maintenance hemodialysis: a cross – sectional study from Palestine
title_full Treatment adherence and perception in patients on maintenance hemodialysis: a cross – sectional study from Palestine
title_fullStr Treatment adherence and perception in patients on maintenance hemodialysis: a cross – sectional study from Palestine
title_full_unstemmed Treatment adherence and perception in patients on maintenance hemodialysis: a cross – sectional study from Palestine
title_short Treatment adherence and perception in patients on maintenance hemodialysis: a cross – sectional study from Palestine
title_sort treatment adherence and perception in patients on maintenance hemodialysis: a cross – sectional study from palestine
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5450383/
https://www.ncbi.nlm.nih.gov/pubmed/28558719
http://dx.doi.org/10.1186/s12882-017-0598-2
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