Adherence in patients on dialysis: strategies for success.
Adherence is a major problem in patients with chronic kidney disease. Patients can be nonadherent with different aspects of their treatment, which includes medications, treatment regimens, and dietary and fluid restrictions. Although many lessons have been learned from adherence research, the evidence of how to modify adherence is somewhat mixed. To minimize nonadherence, interventions need to focus on both patient factors and the extent to which relationships and system problems compromise the patient's ability to adhere to medication and treatment plans. There continues to be a tendency to focus on the patient as the reason for problems with adherence, ignoring other factors such as the patient-health care provider relationships and the health care system that surrounds the patient. These latter factors can have a considerable effect on adherence. The nurse can develop a strong relationship of support with the patient, identify barriers, and offer strategies to help patients improve adherence.
Kammerer
Jean
J
Nephrology Medical Communications, Amgen, Inc., Thousand Oaks, CA, USA. jeankammerer@gmail.com
Garry
Glenn
G
Hartigan
Marguerite
M
Carter
Barbara
B
Erlich
Linda
L
D003299:Cooperative Behavior; D006272:Health Facility Environment; D006301:Health Services Needs and Demand; D006304:Health Status; D006379:Helping Behavior; D006760:Hospitalization; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000523:psychology / Q000628:therapy; D008960:Models, Psychological; D024802:Nurse's Role / Q000523:psychology*; D009723:Nurse-Patient Relations; D009730:Nursing Assessment; D010347:Patient Care Planning; D010349:Patient Compliance / Q000523:psychology*; D010358:Patient Participation / Q000379:methods / Q000523:psychology; D006435:Renal Dialysis / Q000451:nursing / Q000523:psychology; D012307:Risk Factors; D012944:Social Support; D013597:Systems Analysis; D016896:Treatment Outcome