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Keynote webinar | Spotlight on medication adherence

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International Urology and Nephrology
Published in: International Urology and Nephrology 5/2020

01-05-2020 | Chronic Kidney Disease | Nephrology - Review

Factors affecting medication adherence among pre-dialysis chronic kidney disease patients: a systematic review and meta-analysis of literature

Authors: Jun Jie Benjamin Seng, Jia Ying Tan, Cheng Teng Yeam, Htay Htay, Wai Yin Marjorie Foo

Published in: International Urology and Nephrology | Issue 5/2020

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Abstract

Background

Medication adherence plays an essential role in slowing the progression of chronic kidney disease (CKD). This review aims to summarise factors affecting medication adherence among these pre-dialysis CKD patients.

Methods

A systematic review of the literature was performed in Medline®, Embase®, SCOPUS® and CINAHL®. Peer-reviewed, English language articles which evaluated factors associated with medication adherence among pre-dialysis CKD patients were included. Meta-analysis was performed to assess the pooled medication adherence rates across studies. Factors identified were categorised using the World Health Organization’s five dimensions of medication adherence (condition, patient, therapy, health-system, and socio-economic domains).

Results

Of the 3727 articles reviewed, 18 articles were included. The pooled adherence rate across studies was 67.4% (95% CI 61.4–73.3%). The most studied medication class was anti-hypertensives (55.6%). A total of 19 factors and 95 sub-factors related to medication adherence were identified. Among condition-related factors, advanced CKD was associated with poorer medication adherence. Patient-related factors that were associated with lower medication adherence included misconceptions about medication and lack of perceived self-efficacy in medication use. Therapy-related factors which were associated with poorer medication adherence included polypharmacy while health system-based factors included loss of confidence in the physician. Socioeconomic factors such as poor social support and lower education levels were associated with poorer medication adherence.

Conclusion

Factors associated with poor medication adherence among pre-dialysis CKD patients were highlighted in this review. This will aid clinicians in designing interventions to optimise medication adherence among pre-dialysis CKD patients.
Appendix
Available only for authorised users
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Metadata
Title
Factors affecting medication adherence among pre-dialysis chronic kidney disease patients: a systematic review and meta-analysis of literature
Authors
Jun Jie Benjamin Seng
Jia Ying Tan
Cheng Teng Yeam
Htay Htay
Wai Yin Marjorie Foo
Publication date
01-05-2020
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 5/2020
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-020-02452-8

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