Adherence assessment practices in haemodialysis settings: A qualitative exploration of nurses and pharmacists' perspectives

Saurav Ghimire, Kenneth Lee, Matthew D. Jose, Ronald L. Castelino and Syed Tabish R. Zaidi

Journal of Clinical Nursing, 2019, vol. 28, issue 11-12, 2197-2205

Abstract: Aims and objectives To explore clinician assessment of patient adherence and identify strategies to improve adherence assessment practices in haemodialysis settings. Background Patients with chronic kidney disease undergoing haemodialysis are typically prescribed complex regimens; as such, they are at high risk of medication nonadherence. Current clinical practices focus on prescribing medications; however, little attention is paid to measuring and ensuring patient adherence to their prescribed treatments. Design A qualitative study. Methods Semi‐structured individual interviews were conducted in November and December 2016, with 12 nurses and 6 pharmacists, working in Australian haemodialysis settings. The study was conducted and reported in accordance with COREQ guidelines. Results Participants were 25–60 years old and had 1–27 years of experience in dialysis. Seven themes related to assessing adherence were identified: prioritisation of resources, interplay between workload and available time, awareness of formalised adherence measures and training deficits, concerns about practicality/suitability of adherence measures, communication of assessment services, patient participation and trust. Three themes related to strategies for improving adherence assessment practices were identified: formalisation of adherence assessment process, integration of assessment processes and tools into routine, and use of multidisciplinary support to assess and promote adherence. Conclusions Current adherence assessment practices could be improved through formalisation and integration of the assessment process into dialysis unit policy/procedures. Additionally, as barriers to assessing adherence were identified at organisational, professional and patient levels, there is a need to address barriers from each level in order to improve adherence assessment practices in haemodialysis settings. Relevance to clinical practice This qualitative study highlights the challenges and practical ways by which adherence assessment practices could be improved in haemodialysis settings. This would encourage renal clinicians to actively participate in adherence assessment and promotion activities to ensure patients benefit from their therapies.

Date: 2019
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://doi.org/10.1111/jocn.14821

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:wly:jocnur:v:28:y:2019:i:11-12:p:2197-2205

Access Statistics for this article

More articles in Journal of Clinical Nursing from John Wiley & Sons
Bibliographic data for series maintained by Wiley Content Delivery ().