title: Evaluation of adherence to therapy in patients of chronic kidney disease.
abstract: OBJECTIVE
  To evaluate adherence to medication and study factors associated with non-adherence in chronic kidney disease (CKD) patients.
  
  
  METHODS
  A prospective, cross-sectional, questionnaire based study was conducted in Nephrology department of a super specialty hospital. Patients above 18 years of age, suffering from CKD from six months or more were interviewed using self-designed, semi-structured questionnaire to get information about adherence to medication, diet restriction and lifestyle modification (n = 150). Morisky medication adherence questionnaire was used to calculate overall adherence. In this higher score indicates poor adherence. Main outcome measures included prevalence of non-adherence and factors associated with the same.
  
  
  RESULTS
  Average number of medicines taken by each patient was 8.0+1.612 (mean+SD) per day. Non-adherence to medication schedule was reported in 34% patients. Common causes of non-adherence were high cost (21.3%), complex dosing schedule (20%), fear of adverse effects (16%). Sixty-eight% patients were not aware about importance of taking each medicine. Sixteen% stopped taking medicines due to high cost. Forty-two% suggested that government should adopt measures to provide free medicines to poor patients. In Morisky medication adherence questionnaire high, medium and low adherence was reported in 7.3%, 55.3% and 37.3% of patients, respectively. Moderately positive correlation was observed between poor adherence and number of concurrent illnesses and number of medicines taken.
  
  
  CONCLUSIONS
  Since majority of patients were not aware about importance of taking each medicine, creating awareness about the same is essential for improving adherence to therapy. Measures to provide free medicines to non-affording patients need to be implemented since high cost was other major cause of non-adherence.
authors.affiliation: Department of Pharmacology, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Smita
authors.initials: S
authors.lastname: Sontakke
authors.affiliation: Department of Pharmacology, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Ritu
authors.initials: R
authors.lastname: Budania
authors.affiliation: Department of Pharmacology, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Chaitali
authors.initials: C
authors.lastname: Bajait
authors.affiliation: Department of Pharmacology, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Kavita
authors.initials: K
authors.lastname: Jaiswal
authors.affiliation: Department of Pharmacology, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Sonali
authors.initials: S
authors.lastname: Pimpalkhute
mesh_terms: D003131:Combined Modality Therapy / Q000009:adverse effects / Q000191:economics; D003430:Cross-Sectional Studies; D019587:Dietary Supplements / Q000009:adverse effects / Q000191:economics; D004334:Drug Administration Schedule; D016527:Drug Costs; D015444:Exercise; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006782:Hospitals, Special; D006801:Humans; D007194:India; D008019:Life Style; D008297:Male; D019122:Meditation; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D019338:Polypharmacy; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000188:drug therapy / Q000191:economics / Q000628:therapy*; D012648:Self Care / Q000191:economics; D057566:Self Report; D014882:Water-Electrolyte Balance
keywords: Medication nonadherence; morisky medication adherence questionnaire; polypharmacy in chronic kidney disease