#4401 IMPACT OF POLYPHARMACY ON QUALITY OF LIFE IN DUTCH DIALYSIS PATIENTS: A QUALITATIVE STUDY

Abstract

Abstract Background and Aims Almost all dialysis patients have polypharmacy but little is known about their experiences with medication and perception towards it. In this study, we aim to gain insight in dialysis patients’ experiences with polypharmacy the ways they integrate their medication in their daily lives and how it affects their quality of life. Method We conducted a qualitative study among dialysis patients from two Dutch university hospitals and affiliated dialysis clinics. Participants were interviewed in semi-structured interviews based on a pre-selected topic list. Interviews were transcribed verbatim and analysed independently by two researchers through thematic content analysis. Results Overall, 28 participants were interviewed (29% women, mean age 63±16 years, median dialysis vintage 25.5 [IQR 15-48] months, mean number of medications 14±3). Important themes were (1) participants’ own definition of what constitutes ‘medication’, (2) their perception of medication, (3) medication routines and its impact on daily life, and (4) interactions with healthcare professionals and others regarding medication. Participants generally perceived medication as burdensome but less burdensome than dialysis. Medication was accepted as an essential condition for their health even though participants could not always directly notice these health benefits and often relied on their physicians to determine the effectiveness of medication. Medication routines and other coping mechanisms helped participants to reduce the perceived negative effects of medication. In fact, for some participants, medication increased their freedom. Participants generally had constructive relationships with their physicians discussing their medication. Conclusion Polypharmacy negatively affected dialysis patients’ quality of life. These effects were, however, overshadowed by the burden of dialysis. Patients’ realization that medication is of importance for their health and effective coping strategies mitigated the negative impact of polypharmacy on quality of life. Physicians should continuously work together with their patients to evaluate the impact of treatments, not only on health but also on other aspects of patients’ daily lives.