[Pharmaceutical intervention on the therapeutic adherence in patients with chronic renal disease]

To assess the therapeutic adherence in patients with stage 3-5 chronic renal disease (CRD), and evaluate whether pharmaceutical intervention improves medication adherence.

A prospective uncontrolled before-after study (July 2008-March 2009) was carried out in the Pharmaceutical Care Unit of a tertiary hospital. Polymedicated patients >65 years with stage 3-5 CRD, and on treatment with erythropoietin. Infowin(®) program was used to provide written information during the interviews with patients, who signed the informed consent. The Haynes-Sackett and Morisky-Green questionnaires were used to assess the therapeutic adherence.

Of a total of 103 candidates, we asked 94 patients to participate, of whom 53 agreed; women 60.4%, mean age: 76.8 ± 6.9 years.

refusal to participate (19.5%), non-appearance of patient or usual caregiver (70.7%), and institutionalised patients (9.8%). Average number of drugs per patient: 10.8 ± 2.97. A total of 88.7% had no difficulty in taking medication (Haynes-Sackett) and 73.6% were considered compliant (Morisky-Green). Differences were observed when comparing both methods (P=.036). Patients with difficulty in taking medication were less compliant (45.6%). The Morisky-Green questionnaire was used for a second time on 78.6% of unreliable patients, and obtained a 45.5% increase in compliance, increasing the overall compliance to 87.8% (P=.00003). Fifty-two drug-related problems (DRP) were detected.

The initial compliance of patients with stage 3-5 CRD was was noteworthy. However, after pharmaceutical intervention there was a statistically significant improvement in adherence to therapy.