Self-reported adherence to a therapeutic regimen among patients undergoing continuous ambulatory peritoneal dialysis.
OBJECTIVE
This paper is a report of a study conducted to examine self-reported adherence to a therapeutic regimen for continuous ambulatory peritoneal dialysis.


BACKGROUND
Studies of patients' adherence during dialysis have primarily focused on haemodialysis and have frequently yielded inconsistent results, which are attributed to the inconsistent tools used to measure adherence. Levels of adherence to all four components of the therapeutic regimen (i.e. dietary and fluid restrictions, medication, and the dialysis regimen) among patients receiving peritoneal dialysis have not been examined, especially from a patient perspective.


METHODS
A total population sample was used. A cross-sectional survey was carried out by face-to-face interviews in 2005 in one renal clinic in Hong Kong. A total of 173 patients undergoing peritoneal dialysis (56% of the total population) participated in the study.


RESULTS
Patients perceived themselves as more adherent to medication (83%; 95% confidence interval 77-88%) and dialysis (93%; 95% confidence interval 88-96%) prescriptions than to fluid (64%; 95% confidence interval 56-71%) and dietary (38%; 95% confidence interval 30-45%) restrictions. Those who were male, younger or had received dialysis for 1-3 years saw themselves as more non-adherent compared with other patients.


CONCLUSIONS
Healthcare professionals should take cultural issues into consideration when setting dietary and fluid restriction guidelines. Additional attention and support are required for patients who identify themselves as more non-adherent. To help patients live with end-stage renal disease and its treatment, qualitative research is required to understand how they go through the dynamic process of adherence.
Lam
Lai Wah
LW
The Nethersole School of Nursing, The Chinese University of Hong Kong. lwlam@cuhk.edu.hk
Twinn
Sheila F
SF
Chan
Sally W C
SW
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006723:Hong Kong; D006801:Humans; D007676:Kidney Failure, Chronic / Q000178:diet therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000523:psychology*; D012737:Sex Factors; D012959:Socioeconomic Factors; D013997:Time Factors