Improving compliance in dialysis patients: does anything work?

Area of Science:

• Nephrology
• Patient Adherence Research
• Renal Replacement Therapy

Background:

• Noncompliance with prescribed therapy significantly impacts dialysis patient care and outcomes.
• At least 50% of hemodialysis (HD) patients and an estimated 33% of peritoneal dialysis (PD) patients exhibit noncompliance.
• Psychosocial issues, younger age, and smoking are associated with compliance challenges.

Discussion:

• Patient education, individualized attention, supervision, encouragement, and support are advocated strategies to enhance compliance.
• Few interventions have undergone rigorous testing.
• Understanding compliance determinants is crucial for effective patient management.

Key Insights:

• High rates of noncompliance exist in both HD and PD populations.
• Specific patient factors like psychosocial status and age correlate with noncompliance.
• Supportive and educational interventions show promise for improving adherence.

Outlook:

• Further research is needed on psychosocial determinants in both HD and PD patients.
• Longitudinal studies are required to understand compliance behavior patterns over time.
• Defining acceptable compliance variability within treatment goals remains an important area for investigation.