title: Nonadherence in dialysis patients: prevalence, measurement, outcome, and psychological determinants.
abstract: Nonadherence to aspects of the management of End-Stage Kidney Disease (ESKD) is common. Estimates of nonadherence vary with assessment method. Whilst readily available and free from report bias, physiological proxies-frequently used as measures of adherence-are often confounded by clinical factors including residual kidney function and dialysis adequacy. Despite variation in estimates of its prevalence, it is clear that suboptimal adherence to dialysis prescriptions, medication and diet can lead to adverse clinical outcomes. Several factors can help explain nonadherence in ESKD including mood, self-efficacy, social support, illness, and treatment perceptions. Psychological interventions have been shown to improve ESKD adherence, yet achieving long-term behavior change remains challenging. Identifying individuals who struggle to adhere to aspects of the dialysis regime, and tailoring theory-led interventions to improve and support adherence is a clear clinical need requiring further empirical enquiry.
authors.affiliation: School of Medicine, University of Leeds, Leeds, United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Clark
authors.forename: Ken
authors.initials: K
authors.lastname: Farrington
authors.forename: Joseph
authors.initials: J
authors.lastname: Chilcot
mesh_terms: D001294:Attitude to Health; D015415:Biomarkers / Q000097:blood; D003863:Depression / Q000523:psychology; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology / Q000628:therapy*; D010349:Patient Compliance / Q000523:psychology*; D015995:Prevalence; D006435:Renal Dialysis / Q000523:psychology; D020377:Self Efficacy; D057566:Self Report; D012944:Social Support; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers