Department of Internal Medicine, Nephrology Unit, Faculty of Medicine, Suez Canal University, Kilo 4.5, Ring Road, P.O: 41522, Ismailia, Egypt.
Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
BMC Nephrol. 2022 Apr 9;23(1):138. doi: 10.1186/s12882-022-02756-0.
Adherence of patients with End-Stage Renal Disease (ESRD) to Hemodialysis (HD), prescribed medications, diet and fluid restrictions is essential to get the desirable outcome and prevent complications. During COVID-19 pandemic, ESRD patients became more concerned with attending the HD sessions and following the protective measures because of the potential for increased susceptibility to COVID-19. The aim of this study was to evaluate the impact of the pandemic on patients' adherence to HD and medical regimens.
Two hundred five ESRD patients on HD were interviewed with the ESRD Adherence Questionnaire (ESRD-AQ) and the Fear-of-COVID-19 Scale (FCV-19S). Clinical and laboratory correlates of adherence were retrieved from patients' records.
Self-reported adherence to HD showed that 19.5% were not adherent to HD during the pandemic compared to 11.7% before the pandemic (p < 0.001), with a significant agreement with the actual attendance of HD sessions (Kappa = 0.733, p < 0.001). Twenty-five patients (12.2%) had a history of COVID-19. The FCV-19S had a mean score of 18.8 and showed significant positive correlations with the pre-dialysis phosphorus and potassium. Multivariate analysis showed that the main predictors of non-adherence were the history of COVID-19, understanding and perception scores, and the Fear-of-COVID score.
The COVID-19 pandemic adversely affected the adherence of ESRD patients to HD and medical regimen. Strategies to mitigate patients' fears of COVID-19 and improve their understanding and perceptions of adherence to HD and medical regimen should be adopted in HD centers during the pandemic.
终末期肾病（ESRD）患者对血液透析（HD）、处方药物、饮食和液体限制的依从性对于获得理想的结果和预防并发症至关重要。在 COVID-19 大流行期间，由于对 COVID-19 的易感性增加，ESRD 患者更加关注参加 HD 治疗和采取防护措施。本研究旨在评估大流行对患者 HD 治疗和医疗方案依从性的影响。
对 205 名接受 HD 治疗的 ESRD 患者进行了访谈，使用 ESRD 依从性问卷（ESRD-AQ）和 COVID-19 恐惧量表（FCV-19S）。从患者记录中检索与依从性相关的临床和实验室数据。
自我报告的 HD 治疗依从性显示，与大流行前相比（11.7%），大流行期间有 19.5%的患者不依从 HD 治疗（p<0.001），与实际 HD 治疗的出席率具有显著一致性（Kappa=0.733，p<0.001）。25 名患者（12.2%）有 COVID-19 病史。FCV-19S 的平均得分为 18.8，与透析前磷和钾呈显著正相关。多变量分析显示，不依从的主要预测因素是 COVID-19 病史、理解和感知评分以及对 COVID-19 的恐惧评分。
COVID-19 大流行对 ESRD 患者对 HD 治疗和医疗方案的依从性产生了不利影响。在大流行期间，HD 中心应采取措施减轻患者对 COVID-19 的恐惧，提高他们对 HD 治疗和医疗方案依从性的理解和认识。
