Abstract
Pediatric patients with Chronic Kidney Disease face several barriers to medication adherence that, if addressed, may improve clinical care outcomes. A cross sectional questionnaire was administered in the Foundation for Children with Kidney Disease (FUNDANIER, Guatemala City) from September of 2015 to April of 2016 to identify the predisposing factors, enabling factors and need factors related to medication adherence. Sample size was calculated using simple random sampling with a confidence level of 95%, confidence interval of 0.05 and a proportion of 87%. A total of 103 participants responded to the questionnaire (calculated sample size was 96). Independent variables were defined and described, and the bivariate relationship to dependent variables was determined using Odds Ratio. Multivariate analysis was carried out using logistic regression. The mean adherence of study population was 78% (SD 0.08, max = 96%, min = 55%). The mean adherence in transplant patients was 82% (SD 7.8, max 96%, min 63%), and the mean adherence in dialysis patients was 76% (SD 7.8 max 90%, min 55%). Adherence was positively associated to the mother’s educational level and to higher monthly household income. Together predisposing, enabling and need factors illustrate the complexities surrounding adherence in this pediatric CKD population. Public policy strategies aimed at improving access to comprehensive treatment regimens may facilitate treatment access, alleviating economic strain on caregivers and may improve adherence outcomes.
Highlights
Chronic Kidney Disease (CKD) is a rising epidemic known to impact cardiovascular disease risk, life expectancy, overall patient quality of life, and healthcare system costs [1,2]
This study aimed to identify factors associated to acceptable medication adherence among pediatric patients with stage 5 CKD
Recruitment was based on predetermined clinic appointments for stage 5 CKD patients
Summary
Chronic Kidney Disease (CKD) is a rising epidemic known to impact cardiovascular disease risk, life expectancy, overall patient quality of life, and healthcare system costs [1,2]. CKD in adults is associated with older age, hypertension, and diabetes. The etiologies of CKD in some developing countries differ. In agricultural communities in Central America, Egypt, India and Sri Lanka, for example, CKD is commonly presented in male-farmworkers without common risk factors [3].
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