Medication knowledge and compliance among patients receiving long-term dialysis

Abstract

The extent to which patients receiving longterm dialysis understood and complied with their drug therapy regimens was studied. Patients undergoing long-term hemodialysis or continuous ambulatory peritoneal dialysis (CAPD) in a university-affiliated outpatient dialysis center were surveyed to determine their knowledge about and compliance with prescribed regimens for antihypertensives, phosphate binders, and calcitriol. They were asked to list their prescribed medications and state the medications' indications, the frequency with which they missed doses, and the actions they took after missing a dose. The patients were also asked where they obtained their medications and who their primary source of drug information was. Seventy-two patients (51 receiving hemodialysis and 21 receiving CAPD) were surveyed. Although 80% of the patients could recall the three target medications, only 39% of the hemodialysis patients and 57% of CAPD patients could recall all of their medications. Significantly more patients knew the indication for their antihypertensive medication and calcitriol than for their phosphate binder. The hemodialysis and CAPD patients reported they missed an average of 13.0 and 4.7 phosphate binder doses, 2.6 and 5.6 antihypertensive doses, and 6.7 and 7.0 calcitriol doses, respectively, per month. Despite the fact that 70% of the patients received their medications from a community pharmacy, less than 15% identified the pharmacist as their primary source of drug information. Patients receiving long-term hemodialysis or CAPD were more knowledgeable about and compliant with their antihypertensive and calcitriol regimens than their phosphate binder regimens.