Geriatric syndromes are potential determinants of the medication adherence status in prevalent dialysis patients
Journal
PeerJ
Journal Volume
2016
Journal Issue
6
Pages
e2122
Date Issued
2016
Author(s)
Abstract
Background. Geriatric syndromes (GS) exhibit high prevalence in patients with end-stage renal disease (ESRD) under chronic dialysis irrespective of age. We sought to determine whether GS influences medication adherence in ESRD patients. Methods. A prospective cohort of chronic dialysis patients was assembled. The presence of GS components, including frailty/prefrailty, polypharmacy, and malnutrition, were ascertained through a validated questionnaire, electronic records and chart abstraction, and laboratory tests. The severity of medication non-adherence was defined using the eight-item Morisky Medication Adherence Scale (MMAS). Multiple logistic regression analysis was performed targeting MMAS results and incorporating relevant clinical features and GS. Results. The prevalence of frailty/pre-frailty, polypharmacy, and hypoalbuminemia/malnutrition among the enrolled participants was 66.7%, 94%, and 14%, respectively. The average MMAS scores in these dialysis patients were 2±1.7 (range, 0-6), with only 15.7% exhibiting high medication adherence. Multiple regression analyses showed that the absence of frailty/pre-frailty (P = 0.01) were significantly associated with poorer medication adherence, while the presence of polypharmacy (P = 0.02) and lower serum albumin, a potential sign of malnutrition (P = 0.03), were associated with poor adherence in another model. Conclusion. This study is among the very few reports addressing GS and medication adherence, especially in ESRD patients. Interventions targeting frailty, polypharmacy, and malnutrition might potentially improve the medication non-adherence and symptom control in these pill-burdened patients. ? 2016 Chao et al.
SDGs
Other Subjects
albumin; calcium; cholesterol; creatinine; ferritin; glucose; hemoglobin; phosphate; potassium; sodium; triacylglycerol; aged; Article; chronic glomerulonephritis; controlled study; diabetes mellitus; diabetic nephropathy; end stage renal disease; female; geriatric disorder; heart failure; hemodialysis patient; human; hypoalbuminemia; liver cirrhosis; major clinical study; male; malnutrition; medication compliance; Morisky Medication Adherence Scale; polypharmacy; prevalence; prospective study; questionnaire; urea nitrogen blood level; weakness
Publisher
PeerJ Inc.
Type
journal article