Medication Adherence, Burden and Health-Related Quality of Life in Adults with Predialysis Chronic Kidney Disease: A Prospective Cohort Study

Wubshet H. Tesfaye, Charlotte McKercher, Gregory M. Peterson, Ronald L. Castelino, Matthew Jose, Syed Tabish R. Zaidi and Barbara C. Wimmer
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Wubshet H. Tesfaye: Pharmacy, School of Medicine, College of Health and Medicine, University of Tasmania, Hobart 7005, Tasmania, Australia
Charlotte McKercher: Menzies Institute for Medical Research, Hobart 7000, Tasmania, Australia
Gregory M. Peterson: Pharmacy, School of Medicine, College of Health and Medicine, University of Tasmania, Hobart 7005, Tasmania, Australia
Ronald L. Castelino: Sydney Nursing School, The University of Sydney, Sydney 2006, New South Wales, Australia
Matthew Jose: Sydney Nursing School, The University of Sydney, Sydney 2006, New South Wales, Australia
Syed Tabish R. Zaidi: School of Healthcare, University of Leeds, Leeds LS2 9JT, UK
Barbara C. Wimmer: Pharmacy, School of Medicine, College of Health and Medicine, University of Tasmania, Hobart 7005, Tasmania, Australia

IJERPH, 2020, vol. 17, issue 1, 1-13

Abstract: This study examines the associations between medication adherence and burden, and health-related quality of life (HRQOL) in predialysis chronic kidney disease (CKD). A prospective study targeting adults with advanced CKD (estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m 2 ) and not receiving renal replacement therapy was conducted in Tasmania, Australia. The actual medication burden was assessed using the 65-item Medication Regimen Complexity Index, whereas perceived burden was self-reported using a brief validated questionnaire. Medication adherence was assessed using a four-item Morisky-Green-Levine Scale (MGLS) and the Tool for Adherence Behaviour Screening (TABS). The Kidney Disease and Quality of Life Short-Form was used to assess HRQOL. Of 464 eligible adults, 101 participated in the baseline interview and 63 completed a follow-up interview at around 14 months. Participants were predominantly men (67%), with a mean age of 72 (SD 11) years and eGFR of 21 (SD 6) mL/min/1.73 m 2 . Overall, 43% and 60% of participants reported medication nonadherence based on MGLS and TABS, respectively. Higher perceived medication burden and desire for decision-making were associated with nonadherent behaviour. Poorer HRQOL was associated with higher regimen complexity, whereas nonadherence was associated with a decline in physical HRQOL over time. Medication nonadherence, driven by perceived medication burden, was prevalent in this cohort, and was associated with a decline in physical HRQOL over time.

Keywords: chronic kidney disease; medication adherence; health-related quality of life; medication regimen complexity index; medication burden (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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