- Younger patients and patients managing depression are more likely to have low medication adherence, according to a recent survey from the American Kidney Fund (AKF).
The survey of over 1,200 dialysis patients found that patients ages 18 to 39 tend to struggle adhering to both kidney disease medications as well as lifestyle changes necessary for managing their illnesses. Half of this age population have left dialysis sessions early, the survey showed, and 30 percent have skipped session altogether.
Patients ages 18 to 39 were 38 percent less adherent to their kidney disease medications compared to other patient age demographics.
Seventy-one percent of patients 18 to 39 also reported non-adherence to diet and other lifestyle changes necessary for chronic disease management.
Depression also emerged as a predictor for medication non-adherence, the survey revealed. Forty-two percent of patient respondents said depression, fear, or anxiety had kept them from participating in their daily activities at least once in the previous month.
Patients in the 18 to 39 age range were more liable to these depressive symptoms. Thirty-six percent reported debilitating feelings of sadness, compared to only 18 percent of patients ages 40 to 49 and 60 or older. Twenty percent of patients ages 50 to 59 experienced depressive symptoms.
Depression was tied to reports of medication non-adherence, the survey showed. Among patients who reported depressive symptoms at least twice a month, 28 percent skipped a dialysis session. Patients who had never felt a depressive symptom skipped dialysis sessions half as often.
Patients who felt depressed only once a month skipped treatments 30 percent of the time.
Forty percent of patients said sadness, nervousness, or fear had kept them from adhering to a treatment in the previous month.
The survey revealed other causes of medication non-adherence among chronic kidney disease patients. Sixty-nine percent of patients cited forgetfulness. Twenty-three percent of patients skipped a dose after they had already missed one during that week.
Most patients said they did not complete dialysis sessions or did not attend sessions because they were feeling sick, the survey showed.
Of the 58 percent of all patients who stated they did not adhere to diet treatment protocol, 45 percent said they wanted a break from the dietary limitations. Thirty-nine percent said they had difficulty adhering to the diet when eating out.
Healthcare professionals have a role to play in supporting better medical adherence in chronic kidney disease patients. AKF surveyed 400 renal professionals, including about 250 dialysis social workers. These medical professionals stated that limited time for quality patient-provider communication hindered their ability to emphasize the importance of medication adherence.
Medical professional respondents also stated that assistance from a non-clinical caregiver can improve medication adherence in chronic disease patients.
This survey intends to assist clinicians and other renal professionals to better engage patients in medication adherence. Insights about patients at risk for medication non-adherence and the reasons for that non-adherence may help physicians better target patient activation plans, according to AKF president and CEO LaVarne A. Burton.
“The treatment regimen for people living with kidney failure is complex and demanding, yet following the prescribed treatment plan is essential for patients to have the best health outcomes possible,” Burton said in a statement. “Living with kidney failure is enormously challenging for patients, and we want this survey to foster a deeper understanding of patient experiences and challenges so that the entire renal community may more effectively support patients.”
Specifically, medical professionals need to conduct screenings for factors that may limit patients from taking their medications. An mHealth app for managing medications can help mitigate forgetfulness and pill mismanagement, but targeted provider and community intervention may be needed for patients experiencing depressive symptoms.
“A diagnosis of kidney failure is life-changing, and dialysis can be challenging, especially at the outset, when many patients report feeling depressed,” Burton concluded. “Because depression plays such a large role in treatment nonadherence, it’s incumbent upon the entire renal community to work together to find ways to address this and support patients.”