Medication adherence assessment practices in dialysis settings: A survey of renal nurses’ perceptions

Abstract

AIMS AND OBJECTIVES\nTo measure renal nurses perceptions on assessing medication adherence in patients undergoing dialysis.\n\n\nBACKGROUND\nRenal nurses play a vital role in caring for patients undergoing dialysis. Despite the high prevalence of medication nonadherence in chronic dialysis patients, little is known about renal nurses perceptions and current adherence assessment practices.\n\n\nDESIGN\nA cross-sectional survey.\n\n\nMETHODS\nParticipants completed an online survey between March-May 2016. Five psychometric scales were used to measure perception on prevalence and contributors of nonadherence, effective methods of assessment, barriers to assessment and confidence to assess adherence. The survey also captured current adherence assessment practices using a 4-point graded response (1\xa0=\xa0do not practice at all to 4\xa0=\xa0practice for every patient).\n\n\nRESULTS\nA total of 113 dialysis nurses completed the survey. The majority agreed that patients in their unit are nonadherent to their medicines (74.5%, n\xa0=\xa082; median\xa0=\xa08). Most nurses agreed that having dedicated professionals conducting medication history interviews can be effective in identifying nonadherence (88.9%, n\xa0=\xa096; median\xa0=\xa08). Objective assessment through blood results was the most frequently used method to determine nonadherence (83.2%, n\xa0=\xa089), with little attention being paid to patients self-reports of adherence (55.1%, n\xa0=\xa059). Time constraints, administrative support and patients disinterest in discussing medication-related issues with the nurses were perceived as barriers to assessing adherence.\n\n\nCONCLUSIONS\nPatient self-reported measures to assess adherence were underutilised by the renal nurses, whereas objective blood monitoring was routinely used. Overcoming dialysis nurses work-related barriers may facilitate the effective monitoring and promotion of medication adherence in chronic dialysis patients.\n\n\nRELEVANCE TO CLINICAL PRACTICE\nResults from this study emphasise the need for proper assessment of dialysis patient s medication-taking behaviour during routine dialysis to ensure the benefits of prescribed therapies.