Pharmacist-led behavioral change intervention improves adherence and clinical outcomes among hemodialysis patients

Improving adherence enhances therapeutic outcomes in hemodialysis patients; several approaches, including behavioral interventions, were utilized to improve adherence. Examine the effect of a pharmacist-led behavioral change technique (PL-BCT) intervention on hemodialysis patients' adherence to their complex therapeutic regimen and physical indices. Parallel-group, cluster-randomized, controlled trial, in which the patients were divided into usual care and PL-BCT groups. The intervention was developed based on the Behavior Change Technique Taxonomy (v1). Adherence was assessed using the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ). After one month of intervention, the PL-BCT significantly increased the total adherence score compared to usual care (950.0 vs. 825.0). Good adherence rate was higher in the PL-BCT group (42.1% vs. 14.7%). The serum phosphate level (5.83 ± 0.90 vs. 5.84 ± 1.04 mEq/L) and interdialytic weight gain (2.0 vs. 2.9 kg) significantly declined in the PL-BCT compared to usual care. In the unadjusted analysis of the relationship between the intervention of good adherence, there was a 4.592-fold increase in the odds of achieving good adherence in the PL-BCT group compared to usual care OR (95%CI): 4.592 (1.662-12.686), p-value = 0.003; this strong association was maintained in the multivariate analysis. The findings of this study suggest that BCTs support adherence among hemodialysis patients and improve certain clinical indices.Trial Registration The clinical trial registration number is NCT06744738, and the registration date is December 20, 2024.