Medication Adherence and Clinical Outcomes among Patients with Chronic Kidney Disease: A 6-month Prospective...

Medication adherence is a critical issue in managing chronic kidney disease (CKD) patients for slowing CKD progression.

The aim of this study was to evaluate the relationship between individual medication adherence and secondary clinical outcomes (pill burden, medication knowledge, and CKD stages) over a 6-month period. This prospective observational study with repeated measures was performed among patients with CKD in a tertiary hospital in Malaysia.

A prospective observational study was conducted among CKD patients, with assessments at baseline, month 3, and month 6. Individual adherence, pill burden, medication knowledge, and CKD stages were assessed at each visit. Groups were compared using Mann-Whitney U test, Chi-squared, T-test, McNemar test, or ANOVA as necessary.

A total of 200 patients were included, with 140 completing the 6-month follow-up. Medication adherence remained stable over time, with 58.0% (n = 116/200) adherent at baseline, 59.7% (n = 86/144) at month 3, and 59.3% (n = 83/140) at month 6 (all P > 0.05). For the secondary outcomes, adherent patients had a significantly lower pill burden at baseline (mean 9.9 vs. 11.5 pills; P = 0.033), although this was not observed at month 3 or month 6. Medication knowledge scores were consistently higher among adherent patients at baseline (P < 0.001), month 3 (P = 0.002), and month 6 (P < 0.001). CKD stages differed significantly between adherent and nonadherent patients at all time points (baseline, P = 0.005; month 3, P = 0.006; month 6, P = 0.001).

These findings highlight the clinical value of pharmacist-led, medication-level adherence assessment, enabling targeted interventions to optimize therapy, reduce complications, and improve patient outcomes.