A decade review: methods to improve adherence to the treatment regimen among hemodialysis patients

Hemodialysis patients are asked to adhere to a very difficult treatment regimen consisting of fluid and diet restrictions, many daily medications, and, usually, 3- or 4-hour hemodialysis sessions three times each week. Many hemodialysis patients fail to adhere to their prescribed treatment. Although this regimen is difficult, it is necessary for patients to adhere to the prescribed regimen for optimal health and well-being. It is important for nephrology nurses to know what interventions help patients overcome the barriers that keep them from adhering to the prescribed treatment. The purpose of this paper is to review the literature to examine the research that has been published on methods to improve adherence to the treatment regimen among hemodialysis patients. Behavioral approaches, education, and primary nursing are interventions that have been researched. More research has been reported on the demographics of noncompliant hemodialysis patients than on effective methods that help patients improve adherence to the treatment regimen. Demographic characteristics do not consistently predict compliance for individual patients. Each patient is unique. Research supports the idea that the nephrology nurse should spend time with the patient on a regular basis in order to understand the factors that hinder the individual patient from adhering to the treatment regimen. The nurse who knows the patient well is empowered to develop individualized interventions aimed at reducing barriers that interfere with the patient's ability to adhere the prescribed treatment regimen.