Prevalence and Predictors of Medication Non-Adherence in Patients of Chronic Kidney Disease: Evidence from A Cross Sectional Study

Abstract

Introduction: A high level of adherence to prescribed medication is essential to obtain the desired outcomes in patients of chronic kidney disease (CKD). Non-adherence to medication leads to increased morbidity and mortality. Non-adherence to medication has not been studied extensively in patients of CKD in India. Objective: To study the prevalence and predictors of medication non-adherence in patients of CKD. Method: Medication non-adherence was studied with the help of Morisky 8-item Medication Adherence Scale (MMAS-8) through a cross sectional study. Patients, aged 18 yrs or more, diagnosed with CKD according to Kidney Disease: Improving Global Outcomes (KDIGO) definition, and willing to participate in the study were included. On the basis of MMAS-8 scores, patients were classified to have high, medium and low adherence. Binary logistic regression was used to determine the various factors affecting adherence to drug therapy in CKD patients. Results: A total of 150 patients were included in study. Only 22% of the patients had high adherence to medications. Of all, 55% and 23% of the patients belonged to low and medium adherence, respectively. Adherence to drug therapy was found significantly different in different stages of CKD, gender, Body Mass Index (BMI) categories, hemodialysis status, co-morbidities, treatment funding and in patients of different socioeconomic status. Forgetfulness was found to be most common reason for non-adherence, while maximum non-adherence were reported for antihypertensive medications. Pill burden, age, literacy, reimbursement, medication by caregivers was found to significantly affecting the medication adherence. Conclusion: Medication non adherence was found to be highly prevalent in patients of CKD.