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慢性肾脏病透析前患者的药物依从性评估及依从性欠佳的预测因素

Evaluation of medication adherence and predictors of sub-optimal adherence among pre-dialysis patients with chronic kidney disease.

作者信息

Okoro Roland Nnaemeka, Ummate Ibrahim, Ohieku John David, Yakubu Sani Ibn, Adibe Maxwell Ogochukwu, Okonta Mathew Jegbefume

机构信息

Department of Clinical Pharmacy and Pharmacy Administration, University of Maiduguri, Maiduguri, Nigeria.

Department of Medicine, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria.

出版信息

Med Access Point Care. 2020 Sep 16;4:2399202620954089. doi: 10.1177/2399202620954089. eCollection 2020 Jan-Dec.

Abstract

BACKGROUND

Multiple medications are required to effectively manage chronic kidney disease (CKD) and associated complications, posing the risk of poor medication adherence.

OBJECTIVES

To measure medication adherence levels and to investigate the potential predictors of sub-optimal medication adherence in pre-dialysis patients with CKD.

METHODS

A prospective study was conducted in the medical and nephrology outpatients' clinics in Maiduguri. Non-dialysis patients with CKD stages 1-4 aged 18 years and above were recruited through their physicians. The level of medication adherence was determined using Morisky Medication Adherence Scale. Descriptive statistics were used to summarize patients' background characteristics. Multivariate binary logistic regression analyses were performed to investigate the significantly potential predictors of sub-optimal medication adherence at a  < 0.05.

RESULTS

There were 107 participants (48.6%) who had high medication adherence, while 97 (44.1%), and 16 (7.3%) of them had moderate adherence, and low adherence, respectively. The univariate analysis revealed that medication adherence level differed significantly with the number of medications taken daily by patients ( < 0.05). Multivariate logistic regression analyses did not reveal a significant independent predictor of sub-optimal medication adherence.

CONCLUSION

A majority of the participants reported sub-optimal medication adherence. The independent variables considered did not significantly predict sub-optimal medication adherence in the study population. Nevertheless, the study findings highlight the importance of clinical pharmacists' CKD management supportive care to help improve medication adherence.

摘要

背景

有效管理慢性肾脏病(CKD)及其相关并发症需要多种药物,这带来了用药依从性差的风险。

目的

测量透析前CKD患者的用药依从性水平,并调查次优用药依从性的潜在预测因素。

方法

在迈杜古里的内科和肾病门诊进行了一项前瞻性研究。通过医生招募年龄在18岁及以上的1-4期非透析CKD患者。使用Morisky用药依从性量表确定用药依从性水平。描述性统计用于总结患者的背景特征。进行多变量二元逻辑回归分析,以调查在<0.05水平下次优用药依从性的显著潜在预测因素。

结果

107名参与者(48.6%)用药依从性高,而其中97名(44.1%)和16名(7.3%)分别为中度依从性和低依从性。单变量分析显示,用药依从性水平因患者每日服用药物数量的不同而有显著差异(<0.05)。多变量逻辑回归分析未显示次优用药依从性的显著独立预测因素。

结论

大多数参与者报告用药依从性次优。研究中考虑的自变量并未显著预测研究人群中的次优用药依从性。尽管如此,研究结果突出了临床药师对CKD管理支持性护理的重要性,以帮助提高用药依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/012f/9413621/1dcd0f65ebd7/10.1177_2399202620954089-fig1.jpg

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