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Barriers to medication adherence and its relationship with outcomes in pediatric dialysis patients

Douglas M Silverstein1, Angela Fletcher, Kathleen Moylan

  • 1Office of Device Evaluation, Renal Devices Branch (RNDB), United States Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, 20903, USA, dsilverstein2001@yahoo.com.

Pediatric Nephrology (Berlin, Germany)
|February 26, 2014
PubMed

Insights

Medication adherence challenges exist for pediatric dialysis patients. Difficulties were more pronounced in peritoneal dialysis (PD) patients compared to hemodialysis (HD) patients, indicating a need for targeted support.

Area of Science:

  • Pediatric Nephrology
  • Chronic Disease Management
  • Renal Replacement Therapy

Background:

  • Medication adherence is critical for pediatric chronic disease outcomes.
  • Children with end-stage renal disease face complex medication regimens alongside renal replacement therapy.

Purpose of the Study:

  • To assess barriers to medication adherence in pediatric patients undergoing chronic dialysis.
  • To compare adherence challenges between hemodialysis (HD) and peritoneal dialysis (PD) modalities.

Main Methods:

  • A survey of 22 pediatric dialysis patients (63.6% HD, 36.4% PD) assessed medication adherence using a 16-question survey (max score 64).
  • Patient demographics including age and dialysis vintage were recorded.
  • Mineral bone disease markers and treatment targets were evaluated.

Main Results:

  • The overall mean adherence score was 30.9 (range 16-49).
  • Patients on peritoneal dialysis (PD) showed significantly higher mean scores per question (indicating greater difficulty) compared to hemodialysis (HD) patients (p=0.006).
  • No significant relationship was found between adherence scores and gender, age, dialysis vintage, or number of treatment targets reached.

Conclusions:

  • Pediatric dialysis patients encounter numerous barriers to medication adherence.
  • Medication adherence difficulties were more apparent in patients receiving peritoneal dialysis (PD) than hemodialysis (HD).
Abstract

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