Hamza Muhammad Amir, Ullah Shahan, Ahsan Hina, Ali Wajeeha, Masud Mariam, Ahmed Ali
Department of Pharmacy, Faculty of Pharmaceutical Sciences, Riphah International University, Islamabad, Pakistan.
Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Lahore University of Biological and Applied Sciences (UBAS), Lahore, Pakistan.
Int Urol Nephrol. 2025 Apr 4. doi: 10.1007/s11255-025-04472-8.
Medication non-adherence is a prevalent and complicated problem among patients receiving hemodialysis. Strictly following the prescribed medication regimen is crucial for achieving successful dialysis in end-stage renal disease.
This study aimed to investigate how health literacy and illness perception influence medication adherence in hemodialysis patients.
An observational cross-sectional study was conducted from October 2023 to February 2024 at dialysis units of multisite hospitals across Rawalpindi and Islamabad, Pakistan. A pre-validated, reliable, and interview-based questionnaire was utilized, and a convenience sampling technique was employed to collect data from 390 patients. The Statistical Package for the Social Sciences version 23.0 was utilized for statistical analysis.
More than half of the dialysis patients were female, 52.8%, 31% were between the ages of 46-60, and 66.6% had minimal or no education. Of the patients studied, 45.1% exhibited inadequate health literacy, 46.7% held negative perceptions of their illness, and 41.8% demonstrated low levels of medication adherence. The study found a weak correlation: a negative correlation between health literacy and illness perception (r = - 0.080), a positive correlation between health literacy and medication adherence (r = 0.024), and a negative correlation between illness perception and medication adherence (r = -0.061), none of which were statistically significant.
A considerable proportion of the patients demonstrate low medication adherence, inadequate health literacy, and negative perceptions of their illness, highlighting the urgent need for targeted interventions. Structured educational programs, motivational interviewing, individual or group support, and in-person or remote (web- or telephone-based) counseling can help address these issues. Additionally, healthcare professionals-led interventions by doctors, pharmacists, and nurses play a crucial role in raising awareness, enhancing medication adherence, and optimizing treatment outcomes.
在接受血液透析的患者中，药物治疗依从性是一个普遍且复杂的问题。严格遵循规定的药物治疗方案对于终末期肾病患者成功进行透析至关重要。
本研究旨在调查健康素养和疾病认知如何影响血液透析患者的药物治疗依从性。
2023年10月至2024年2月在巴基斯坦拉瓦尔品第和伊斯兰堡多家医院的透析科室进行了一项观察性横断面研究。采用经过预验证、可靠且基于访谈的问卷，并运用便利抽样技术从390名患者中收集数据。使用社会科学统计软件包第23.0版进行统计分析。
超过一半的透析患者为女性（52.8%），31%的患者年龄在46 - 60岁之间，66.6%的患者受教育程度极低或未接受教育。在研究的患者中，45.1%表现出健康素养不足，46.7%对自身疾病持有负面认知，41.8%表现出较低的药物治疗依从性。研究发现存在微弱相关性：健康素养与疾病认知之间呈负相关（r = -0.080），健康素养与药物治疗依从性之间呈正相关（r = 0.024），疾病认知与药物治疗依从性之间呈负相关（r = -0.061），但均无统计学意义。
相当一部分患者表现出较低的药物治疗依从性、健康素养不足以及对自身疾病的负面认知，凸显了针对性干预的迫切需求。结构化教育项目、动机性访谈、个体或团体支持以及面对面或远程（基于网络或电话）咨询有助于解决这些问题。此外，由医生、药剂师和护士主导的医疗专业人员干预在提高认知、增强药物治疗依从性和优化治疗效果方面发挥着关键作用。
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