Efficacy of Fluid Distribution Timetable on the Treatment Adherence of Patients with End-stage Renal Disease: a Randomized Controlled Trial

Abstract

Fluid restriction non-adherence poses a substantial challenge in the management of patients undergoing hemodialysis, contributing to adverse health outcomes such as increased intradialytic weight gain and electrolyte imbalances. This study aimed to evaluate the effectiveness of a fluid distribution timetable in promoting adherence to fluid restriction among individuals with end-stage renal disease undergoing hemodialysis. Conducted from January to February 2023, the randomized controlled trial enrolled 40 patients who were assigned either to receive the fluid distribution timetable or standard care in a single-blind manner. The results demonstrated statistically significant differences in thirst scores between the treatment and control groups during weeks three and four of follow-up, with partial eta-squared values of 0.56 and 0.42, respectively. Moreover, participants in the treatment group reported decreased thirst and interdialytic weight gain, consistent with previous research findings. Qualitative analysis revealed additional insights into the physical benefits, psychological effects, and appropriateness of the intervention, as well as suggestions for improvement. Participants expressed appreciation for the simplicity and clarity of the tool, while also highlighting the potential for digital adaptation and personalized scheduling to enhance its effectiveness. Despite initial challenges, such as adjusting to the intervention, many participants overcame barriers with the support of healthcare providers and recognized the intervention's value in promoting adherence to fluid restriction. In conclusion, these findings underscore the importance of patient-centered approaches in healthcare delivery, emphasizing the need for tailored interventions to optimize outcomes in hemodialysis patients.