Amado Leonilde, Ferreira Nuno, Miranda Vasco, Meireles Patricia, Povera Verónica, Ferreira Ricardo, Fazendeiro-Matos João, Teixeira Laetitia, Paúl Constança, Santos-Silva Alice, Costa Elísio
Nephrocare Portugal, SA-Nephrocare Maia, Maia, Portugal.
Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, Portugal.
J Ren Care. 2015 Dec;41(4):231-8. doi: 10.1111/jorc.12127. Epub 2015 May 4.
Non-adherence to therapeutic regimens is a recognised problem in the dialysis population that compromises the opportunity to achieve maximum treatment effect and, therefore, might lead to increased morbidity and mortality. In this study, we aimed to evaluate the prevalence of self-reported medication non-adherence in patients with end-stage kidney disease (ESKD) undergoing online-haemodiafiltration (OL-HDF), as well as to evaluate the factors that could affect medication adherence.
We evaluated 122 patients with ESKD undergoing OL-HDF. Patients' reported medication adherence was measured by the Measure Treatment Adherence (MTS) scale. Social support was evaluated by the abbreviated Lubben Social Network Scale (LSNS); depression status by the Geriatric Depression Scale (GDS). Socio-demographic, co-morbidity and clinical data were also evaluated.
Our results showed that 10.7% of patients with ESKD perceived themselves as non-adherent to medication. When two groups of patients (adherent and non-adherents) were compared, significantly higher levels of triglycerides, and higher diastolic and systolic blood pressure were found in the non-adherent group. Significant correlations were found between the MTS score, and diastolic blood pressure, age and GDS score. Multiple regression analysis identified age and the GDS score as independent variables significantly associated with the MTS score.
Non-adherence to therapeutic regimens in patients with ESKD is associated with higher levels of triglycerides and higher blood pressure and are, therefore, at a higher cardiovascular risk. Moreover, we found that age and depression status are important variables in non-adherence to therapeutic regimens.
不遵守治疗方案是透析人群中一个公认的问题，这会影响实现最大治疗效果的机会，因此可能导致发病率和死亡率上升。在本研究中，我们旨在评估接受在线血液透析滤过（OL-HDF）的终末期肾病（ESKD）患者自我报告的药物治疗不依从率，并评估可能影响药物依从性的因素。
我们评估了122例接受OL-HDF的ESKD患者。通过治疗依从性测量（MTS）量表来衡量患者报告的药物依从性。通过简化的鲁本社交网络量表（LSNS）评估社会支持；通过老年抑郁量表（GDS）评估抑郁状态。还评估了社会人口统计学、合并症和临床数据。
我们的结果显示，10.7%的ESKD患者认为自己不依从药物治疗。当比较两组患者（依从组和不依从组）时，发现不依从组的甘油三酯水平显著更高，舒张压和收缩压也更高。在MTS评分与舒张压、年龄和GDS评分之间发现了显著相关性。多元回归分析确定年龄和GDS评分是与MTS评分显著相关的独立变量。
ESKD患者不遵守治疗方案与较高的甘油三酯水平和较高的血压相关，因此心血管风险更高。此外，我们发现年龄和抑郁状态是不遵守治疗方案的重要变量。
