The Pharmacist Role In Improving Medication Adherence In Dialysis Patients: A Systematic Review

Abstract

End-stage renal disease (ESRD) is a worldwide concern in this latest generation as the prevalence had been in an increasing trend. This research aims to evaluate the impact of pharmacist interventions on medication adherence and factors related to medications non-adherence among hemodialysis (HD) patients. A literature search was conducted using search engines PubMed, Cochrane Library and ScienceDirect to identify studies that investigate the pharmacist interventions on medication adherence and factors related to medication non-adherence among HD patients. Based on the study objective a qualitative assessment of the final selected articles was made. The quality of the included studies was assessed using the Newcastle-Ottawa scale. Seven studies met the inclusion criteria. The summed overall quality using the Newcastle-Ottawa scale of all the selected paper was good. The majority of the studies were conducted as prospective study design. More than half of the studies (71%) utilized subjective measure which is self-reporting with a validated questionnaire such as Medication Adherence Report Scale (MARS), Brief Medication Questionnaire (BMQ) and Morisky 8-item Medication Adherence Scale (MMAS-8) to measure participants’ adherence. The selected papers have shown that poor medication knowledge as the main factor for non-adherence towards medications. The most common reported pharmaceutical care done by the pharmacist to improve medication adherence is by providing medication counselling. All the studies demonstrate the positive impact of pharmacist involvement in HD patients to enhance medication adherence. All identified studies prove that clinical pharmacists could play an important role in educating patients which helps them to have a positive attitude towards medications.