title: [Pharmaceutical intervention on the therapeutic adherence in patients with chronic renal disease].
abstract: OBJECTIVE
  To assess the therapeutic adherence in patients with stage 3-5 chronic renal disease (CRD), and evaluate whether pharmaceutical intervention improves medication adherence.
  
  
  METHODS
  A prospective uncontrolled before-after study (July 2008-March 2009) was carried out in the Pharmaceutical Care Unit of a tertiary hospital. Polymedicated patients >65 years with stage 3-5 CRD, and on treatment with erythropoietin. Infowin(®) program was used to provide written information during the interviews with patients, who signed the informed consent. The Haynes-Sackett and Morisky-Green questionnaires were used to assess the therapeutic adherence.
  
  
  RESULTS
  Of a total of 103 candidates, we asked 94 patients to participate, of whom 53 agreed; women 60.4%, mean age: 76.8 ± 6.9 years.
  
  
  METHODS
  refusal to participate (19.5%), non-appearance of patient or usual caregiver (70.7%), and institutionalised patients (9.8%). Average number of drugs per patient: 10.8 ± 2.97. A total of 88.7% had no difficulty in taking medication (Haynes-Sackett) and 73.6% were considered compliant (Morisky-Green). Differences were observed when comparing both methods (P=.036). Patients with difficulty in taking medication were less compliant (45.6%). The Morisky-Green questionnaire was used for a second time on 78.6% of unreliable patients, and obtained a 45.5% increase in compliance, increasing the overall compliance to 87.8% (P=.00003). Fifty-two drug-related problems (DRP) were detected.
  
  
  CONCLUSIONS
  The initial compliance of patients with stage 3-5 CRD was was noteworthy. However, after pharmaceutical intervention there was a statistically significant improvement in adherence to therapy.
authors: Servicio de Farmacia, Hospital Universitario Fundación Alcorcón, Alcorcón, España. margasanchezg@hotmail.com
authors: M
authors: M
authors: Sánchez-Gili
authors: P
authors: P
authors: Toro-Chico
authors: M
authors: M
authors: Pérez-Encinas
authors: A M
authors: AM
authors: Gómez-Pedrero
authors: J M
authors: JM
authors: Portolés-Pérez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications / Q000188:drug therapy; D037001:Directive Counseling; D017598:Efficiency, Organizational; D057286:Electronic Health Records; D055695:Electronic Prescribing; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D008297:Male; D055118:Medication Adherence; D010353:Patient Education as Topic; D010595:Pharmacists; D019338:Polypharmacy; D011446:Prospective Studies; D011994:Recombinant Proteins; D012380:Role; D011795:Surveys and Questionnaires
chemical_list: D011994:Recombinant Proteins; D004921:Erythropoietin