Effects of treatment adherence and patient activation on health care utilization in chronic kidney disease

Abstract

ABSTRACT Introduction : Health care utilization (HCU), which is an important health outcome indicator, can also reflect the effectiveness of self-management in chronic conditions. Patient-centered care can play an important role in minimizing unnecessary service use. Objectives The aim was to determine the effects of treatment adherence, patient activation on HCU in Turkish patients with chronic kidney disease. Methods This study had a cross sectional, descriptive exploratory design. It was conducted with 328 patients. Patients’ HCU was evaluated using hospitalization rate, number of hospital nephrology department visits, emergency department visits, and medications used as well as out-of-pocket payments. Multiple regression models were performed to determine the factors affecting HCU. Results Older age, having a comorbidity, and non-adherence to nutritional recommendations and drug treatments were associated with increased hospital visits. Non-adherence to fluid constraint was associated with more hospitalizations, visits to the emergency department, and drugs used. Study results showed that HCU was increased in patients with non-adherence and low activation. Conclusion: Strategies to reduce HCU should aim to improve treatment adherence and activation. It is recommended to train healthcare managers and support nurses organizationally to empower patients, and plan patient-centered care.