Abstract
BackgroundEnd-Stage Renal Disease (ESRD) is the final and permanent stage of Chronic Kidney Disease (CKD). Hemodialysis (HD) is the most common treatment for CKD. To have desirable therapeutic outcomes, patients have to adhere to a specific therapeutic regimen that reduces the hospitalization rate and side-effects of HD. The present study aimed to determine the effects of the patient education program and nurse-led telephone follow-up on adherence to the treatment in hemodialysis patients.MethodsThis is a randomized controlled trial in which a total of 66 patients were recruited using convenience sampling and then randomly assigned to two groups of control (n = 33) and intervention (n = 33). Data were collected using a demographic questionnaire, the laboratory results record sheet, and the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ), which included four dimensions of HD attendance, medication use, fluid restrictions, and diet recommendations. The intervention group received a patient education program and nurse-led follow-up services through telephone communication and the Short Message Service (SMS) for 3 months. All participants filled in the questionnaire before and after the intervention. Data were analyzed using IBM SPSS Statistics for Windows, version 25 (IBM Corp., Armonk, N.Y., USA).ResultsThe results showed a significant difference in the mean scores of HD attendance, medication use, fluid restrictions, and diet recommendations between the two groups immediately, 1 month, and 3 months after the intervention (p < .001). The results also indicated a significant difference in the mean scores of four dimensions during the four-time points of measurement in the intervention group (P < 0.0005). Therefore, the level of treatment adherence in the intervention group was higher than in the control group. Moreover, there was a significant difference in the mean score of laboratory values between the two groups after the intervention, except for the level of serum sodium (P = 0.130).ConclusionImplementation of the patient education program and nurse-led follow-up can lead to better adherence to hemodialysis in four dimensions of HD attendance, medication use, fluid restrictions, and dietary recommendations in HD patients.Trial registrationIRCT registration number: IRCT20190127042512N1; Registration date: 2020-09-12; Registration timing: retrospectively registered: Last update: 2020-09-12.
Highlights
End-Stage Renal Disease (ESRD) is the final and permanent stage of Chronic Kidney Disease (CKD)
In terms of education level, more than half of the participants (54.5%) had a high school diploma and lower in the control group, but only 39.4% had a high school diploma and lower in the intervention group. In both groups, the most dialysis vintage was related to 2–5 years, and in the control and intervention groups, the highest comorbidity was related to hypertension (21.2%) and diabetes (21.2%), respectively (Table 1)
The results of this study indicated that the patient education program and nurse-led telephone follow-up could improve treatment adherence in the four dimensions of HD attendance, medication use, fluid restrictions, and diet recommendations in HD patients
Summary
End-Stage Renal Disease (ESRD) is the final and permanent stage of Chronic Kidney Disease (CKD). Chronic Kidney Disease (CKD) is a general health risk factor worldwide with a higher prevalence in individuals older than 60 years old [1, 2]. End-Stage Renal Disease (ESRD) is the final stage of CKD and is defined as an irreversible decrease in kidney function as there is a need for a regular course of long-term hemodialysis or a kidney transplant to sustain life [7]. According to the health statistics, the number of CKD patients in Iran was more than 55,000 in 2016, out of which 27,500 received Hemodialysis (HD) and 1600 received Peritoneal Dialysis (PD) [11]
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