Author(s): Sally Omar Tawfik Abbas Ebeid, Dixon Thomas, Rajaram Jagdale, Aji Gopakumar, Danial Baker

Email(s): dr.dixon@gmu.ac.ae , dixon.thomas@gmail.com

DOI: 10.52711/0974-360X.2023.00717   

Address: Sally Omar Tawfik Abbas Ebeid1, Dixon Thomas1, Rajaram Jagdale2, Aji Gopakumar3, Danial Baker4
1College of Pharmacy, Gulf Medical University, Ajman, UAE.
2Department of Nephrology, Thumbay University Hospital, Ajman, UAE.
3Data and Statistics/Healthcare/ EHS, Dubai, UAE.
4College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, USA.
*Corresponding Author

Published In:   Volume - 16,      Issue - 9,     Year - 2023


ABSTRACT:
Objectives: The study objective was to assess the impact of pharmacists’ counseling on treatment adherence of patients undergoing maintenance hemodialysis. Methods: This was a quasi-experimental interventional study with four months of follow-up. An indirect method was used to assess adherence and self-report from patients. A modified and validated version of the Greek simplified Medication Adherence questionnaire for hemodialysis patients was used. Patient counseling by the pharmacist was described as a semi-structured approach. A comparison of the scores in each month was performed using Repeated-measures ANOVA. Friedman's test, Wilcoxon signed-rank test, Cochran's Q test, McNemar test. Results: A significant improvement in % of medication adherence over the months (p<0.001, by Cochran’s Q test). There was a significant improvement in fluid adherence in every pair of months, except for months 1 to 2 (by Repeated-measures ANOVA tests). The mean rank shows diet adherence was improved from months 1, months 2, 3, and 4 (Friedman’s test, p<=0.001). The pairwise comparison shows that diet adherence was found to be statistically significant between months 1 and 2, 3, and 4 (P<0.05). All the other pairwise comparison shows no difference. Repeated measure ANOVA shows mean of the weight gain is reduced from months 1 to 2, 3, and 4(p <0.001). Conclusion: The patients improved in treatment adherence in four months. Pharmacists' counseling, along with the services of other healthcare professionals, positively affected patient adherence. Therefore, we recommend that pharmacy counseling services be added to the services available to hemodialysis patients.


Cite this article:
Sally Omar Tawfik Abbas Ebeid, Dixon Thomas, Rajaram Jagdale, Aji Gopakumar, Danial Baker. Impact of Pharmacist Counseling on Treatment Adherence Outcomes of patients undergoing Maintenance Hemodialysis. Research Journal of Pharmacy and Technology 2023; 16(9):4384-0. doi: 10.52711/0974-360X.2023.00717

Cite(Electronic):
Sally Omar Tawfik Abbas Ebeid, Dixon Thomas, Rajaram Jagdale, Aji Gopakumar, Danial Baker. Impact of Pharmacist Counseling on Treatment Adherence Outcomes of patients undergoing Maintenance Hemodialysis. Research Journal of Pharmacy and Technology 2023; 16(9):4384-0. doi: 10.52711/0974-360X.2023.00717   Available on: https://www.rjptonline.org/AbstractView.aspx?PID=2023-16-9-61


REFERENCES:
1.    Ghimirey A., Sapkota B., Shrestha S., Basnet N., Shankar P.R., Sapkota S. Evaluation of pharmacist counseling in improving knowledge, attitude, and practice in chronic kidney disease patients. SAGE Open Medicine. 2013 18;1:2050312113516111. doi: 10.1177/2050312113516111.
2.    Srinivassan K. A descriptive study to assess the knowledge on dietary management among chronic renal failure patients undergoing hemodialysis at selected hospital, Kanchipuram. International Journal of Nursing Education and Research. 2014; 2(3):241-4.
3.    Collins A.J., Foley R.N., Herzog C., Chavers B.M., Gilbertson D., Ishani A., Kasiske B.L., Liu J., Mau L.W., McBean M., Murray A. Excerpts from the US renal data system 2009 annual data report. American Journal of Kidney Diseases. 2010;55(1): A6-7. doi: 10.1053/j.ajkd.2009.10.009.
4.    Flythe J.E. Turning the tide: improving fluid Management in Dialysis through technology. Journal of the American Society of Nephrology. 2017;28(8):2260-2.doi: 10.1681/ASN.2017050491
5.    Rayyani M., Malekyan L., Forouzi M.A., Haghdoost A., Razban F. Self-care self-efficacy and quality of life among patients receiving hemodialysis in South-East of Iran. Asian Journal of Nursing Education and Research. 2014;4(2):165-71.
6.    Thomas A., Sunny A., Jose J., Varghese S., Tessy A., Ravindran R. Effectiveness of self Instructional Module on Knowledge regarding Home care Management among Patients undergoing Hemodialysis in selected Hospitals at Kollam. Asian Journal of Nursing Education and Research. 2019;9(3):415-21.
7.    Duenhas M.R., Draibe S.A., Avesani C.M., Sesso R., Cuppari L. Influence of renal function on spontaneous dietary intake and on nutritional status of chronic renal insufficiency patients. European Journal of Clinical Nutrition. 2003;57(11):1473-8.doi: 10.1038/sj.ejcn.1601713.
8.    Kalantar-Zadeh K., Block G., McAllister C.J., Humphreys M.H., Kopple J.D. Appetite and inflammation, nutrition, anemia, and clinical outcome in hemodialysis patients. The American Journal of Clinical Nutrition. 2004 Aug 1;80(2):299-307.doi: 10.1093/ajcn/80.2.299.
9.    Nelson R.G., Tuttle K.R. The new KDOQITM clinical practice guidelines and clinical practice recommendations for diabetes and CKD. Blood Purification. 2007;25(1):112-4.doi: 10.1053/j.ajkd.2006.12.005
10.    Hagens K., Caine Bish K., CaineBish N. The Effect of Renal Diet and Renal Symptom Knowledge on Dietary Adherence in Adult Hemodialysis Patients. Journal of the Academy of Nutrition and Dietetics. 2019 ;119(10): A132. doi: https://doi.org/10.1016/j.jand.2019.08.113
11.    Murali K.M., Mullan J., Roodenrys S., Hassan H.C., Lambert K., Lonergan M. Strategies to improve dietary, fluid, dialysis or medication adherence in patients with end-stage kidney disease on dialysis: A systematic review and meta-analysis of randomized intervention trials. PloS One. 2019;14(1): e0211479.doi: 10.1371/journal.pone.0211479.
12.    Kara B., Caglar K., Kilic S. Nonadherence with diet and fluid restrictions and perceived socialsupport in patients receiving hemodialysis. Journal of Nursing Scholarship. 2007;39(3): 243-8. Doi: 10.1111/j.1547-5069.2007.00175.x
13.    Setayesh M., Dehghan M., Malakotikhoh A. Effect of an educational program on attitudes and behaviors toward adherence to therapeutic regimen among hemodialysis patients: A randomized clinical trials. Asian Journal of Nursing Education and Research. 2021;11(2):163-8.
14.    Rao I. A study to assess the Effectiveness of Structured Teaching programme on Knowledge regarding Lifestyle Indrawati Rao. Modification among Hemodialysis Patients in Shree Sardar Smarak Hospital, Bardoli. International Journal of Nursing Education and Research. 2015; 3(3): 269-274.doi: 10.1111/j.1547-5069.2007.00175.x
15.    Chironda G., Bhengu B. Contributing factors to nonadherence among chronic kidney disease (CKD) patients: a systematic review of literature. Medical and Clinical Reviews. 2016;2(04):1-9.doi: 10.21767/2471-299X.1000038
16.    Mukakarangwa M.C., Chironda G., Bhengu B., Katende G. Adherence to hemodialysis and associated factors among end-stage renal disease patients at selected nephrology units in Rwanda: A descriptive cross-sectional study. Nursing Research and Practice. 2018 doi: 10.1155/2018/4372716.
17.    De Bleser L., Matteson M., Dobbels F., Russell C., De Geest S. Interventions to improve medication‐adherence after transplantation: a systematic review. Transplant International. 2009;22(8):780-97.doi: 10.1111/j.1432-2277.2009.00881.x.
18.    Valsaraj B.P., Bhat S.M., Prabhu R., Kamath A. Follow-Up Study on the Effect of Cognitive Behaviour Therapy on Haemodialysis Adherence: A randomised controlled trial. Sultan Qaboos University Medical Journal. 2021;21(1):e58.doi: 10.18295/squmj.2021.21.01.008.
19.    Alikari V., Matziou V., Tsironi M., Kollia N., Theofilou P., Aroni A., Fradelos E., Zyga S. A modified version of the Greek Simplified Medication Adherence Questionnaire for hemodialysis patients.Health psychology research. 2017;5(1).doi: 10.4081/hpr.2017.6647.
20.    Daifi C., Feldpausch B., Roa P.A., Yee J. Implementation of a Clinical Pharmacist in a HemodialysisFacility: A Quality Improvement Report. Kidney Medicine. 2021;3(2):241-7.doi: 10.1016/j.xkme.2020.11.015.
21.    John L. A Study to assess the Renal Dietary Adherence among Patients undergoing Hemodialysis in selected Hospital, Bangalore with a view to develop Informational Pamphlet. International Journal of Nursing Education and Research. 2017;5(4):356-8.
22.    Shaikh S.A. A Comparative Study on the Efficacy of Two Teaching Strategies on the care of client with Hemodialysis in terms of Knowledge among the students of selected schools of Nursing, Belgaum District. Karnataka. Asian Journal of Nursing Education and Research. 2022;12(2):187-90.
23.    Drüeke T.B., Locatelli F., Clyne N., Eckardt K.U., Macdougall I.C., Tsakiris D., Burger H.U. Scherhag A.Normalization of hemoglobin level in patients with chronic kidney disease and anemia. New England Journal of Medicine. 2006; 355(20):2071-84.doi: 10.1056/NEJMoa062276.
24.    Pfeffer M.A., Burdmann E.A., Chen C.Y., Cooper M.E., De Zeeuw D., Eckardt K.U., Feyzi J.M., Ivanovich P.,Kewalramani R., Levey A.S., Lewis E.F. A trial of darbepoetin alfa in type 2 diabetes and chronic kidney disease. New England Journal of Medicine. 2009 ;361(21):2019-32.doi: 10.1056/NEJMoa0907845.
25.    Singh A.K. Does TREAT give the boot to ESAs in the treatment of CKD anemia?. Journal of the American Society of Nephrology. 2010;21(1):2-6.doi: 10.1681/ASN.2009111127.
26.    Cui Y., Wu Q., Zhou Y. Iron-refractory iron deficiency anemia: new molecular mechanisms. Kidney international. 2009;76(11): 1137-41.doi: 10.1038/ki.2009.357.
27.    Shoben A.B., Rudser K.D., De Boer I.H., Young B., Kestenbaum B. Association of oral calcitriol with improved survival in nondialyzed CKD. Journal of the American Society of Nephrology. 2008;19(8):1613-9.doi: 10.1681/ASN.2007111164
28.    De Brito-Ashurst I., Varagunam M., Raftery M.J., Yaqoob M.M. Bicarbonate supplementation slows the progression of CKD and improves nutritional status. Journal of the American Society of Nephrology. 2009 Sep 1;20(9):2075-84.oi: 10.1681/ASN.2008111205.
29.    Tonelli M., Pannu N., Manns B. Oral phosphate binders in patients with kidney failure. New England Journal of Medicine. 2010;362(14):1312-24.doi: 10.1056/NEJMra0912522.
30.    Pottie K., Farrell B., Haydt S., Dolovich L., Sellors C., Kennie N., Hogg W., Martin C.M. Integrating pharmacists into family practice teams: physicians’ perspectives on collaborative care. Canadian Family Physician. 2008;54(12):1714-7.
31.    Manohar D.K., Amol A. P., Hrithik S.A., Sayali P.P., Vaishnavi V.B. Importance of Communication and relation between Pharmacist and patient. Asian Journal of Pharmaceutical Research. 2022; 12(2):176-8.doi: 10.52711/2231-5691.2022.00028  
32.    Salgado T.M., Moles R., Benrimoj S.I., Fernandez-Llimos F. Pharmacists’ interventions in the management of patients with chronic kidney disease: a systematic review. Nephrology Dialysis Transplantation. 2012;27(1):276-92.doi: 10.1093/ndt/gfr287.
33.    Joy M.S., DeHart R.M., Gilmartin C., Hachey D.M., Hudson J.Q., Pruchnicki M., Dumo P., Grabe D.W., Saseen J.,Zillich A.J. Clinical pharmacists as multidisciplinary health care providers in the management of CKD: a joint opinion by the Nephrology and Ambulatory Care Practice and Research Networks of the American College of Clinical Pharmacy. American Journal of Kidney Diseases. 2005;45(6):1105-18.doi: 10.1053/j.ajkd.2005.02.027.
34.    Legris M.É., Séguin N.C., Desforges K., Sauvé P., Lord A., Bell R., Berbiche D., Desrochers J.F., Lemieux J.P.,Morin‐Bélanger C., Ste‐Marie Paradis F. Pharmacist web‐based training program on medication use in chronic kidney disease patients: Impact on knowledge, skills, and satisfaction. Journal of Continuing Education in the Health Professions. 2011;31(3):140-50.doi: 10.1002/chp.20119.
35.    Stemer G., Lemmens-Gruber R. Clinical pharmacy activities in chronic kidney disease and end-stage renal disease patients: a systematic literature review. BMC Nephrology. 2011;12(1):1-2.oi: 10.1186/1471-2369-12-35.
36.    Palmer S.C., De Berardis G., Craig J.C., Tong A., Tonelli M., Pellegrini F., Ruospo M., Hegbrant J., Wollheim C.,Celia E., Gelfman R. Patient satisfaction with in-centre haemodialysis care: an international survey. BMJ Open. 2014;4(5):e005020.doi: 10.1136/bmjopen-2014-005020.
37.    Abraham S., Venu A., Ramachandran A., Chandran P.M., Raman S. Assessment of quality of life in patients on hemodialysis and the impact of counseling. Saudi Journal of Kidney Diseases and Transplantation. 2012;23(5):953.doi: 10.4103/1319-2442.100875.
38.    FIP. Joint FIP/WHO Guidelines on GPP: Standards for quality of pharmacy services. The Hague. 2011.
39.    Dispensing Errors and Counseling Quality in 100 Pharmacies. [(accessed on August 12, 2021)]; Available online: http://abcnews.go.com/images/WNT/ross_auburn_final_summary.pdf
40.    Okumura L.M., Rotta I., Correr C.J. Assessment of pharmacist-led patient counseling in randomized controlled trials: a systematic review. International Journal of Clinical Pharmacy. 2014;36(5):882-91.doi: 10.1007/s11096-014-9982-1.
41.    Yamada K., Nabeshima T. Pharmacist-managed clinics for patient education and counseling in Japan: current status and future perspectives. Journal of Pharmaceutical Health Care and Sciences. 2015;1(1):1-8.doi: 10.1186/s40780-014-0001-4.
42.    Salgado T.M., Correr C.J., Moles R., Benrimoj S.I., Fernandez-Llimos F. Assessing the implementability of clinical pharmacist interventions in patients with chronic kidney disease: an analysis of systematic reviews. Annals of Pharmacotherapy. 2013; 47(11): 1498-506.doi: 10.1177/1060028013501802.
43.    Piccoli G.B., Nielsen L., Gendrot L., Fois A., Cataldo E., Cabiddu G. Prescribing hemodialysis or hemodiafiltration: when one size does not fit all the proposal of a personalized approach based on comorbidity and nutritional status. Journal of Clinical Medicine. 2018;7(10):331.doi: 10.3390/jcm7100331.
44.    Soriano G.P. Depression and quality of life among Chronic Kidney Disease Patients on Hemodialysis at selected Stand-alone Renal Facilities in Manila: A cross-sectional study. Asian Journal of Nursing Education and Research. 2019; 9(2):251-5.
45.    Mary A.S., Priya N.G. A study to assess the health related quality of life among clients undergoing hemodialysis in selected hospitals at Bangalore with a view to develop an information booklet. Asian Journal of Nursing Education and Research. 2016; 6(4):425-8.
46.    Stemer G., Lemmens-Gruber R. Clinical pharmacy activities in chronic kidney disease and end-stage renal disease patients: a systematic literature review. BMC Nephrology. 2011;12(1):1 2.doi: 10.1186/1471-2369-12-35.
47.    Abu Ruz S.M., Alrashdan Y., Jarab A., Jaber D., Alawwa IA. Evaluation of the impact of pharmaceutical care service on hospitalized patients with chronic kidney disease in Jordan. International Journal of Clinical Pharmacy. 2013;35(5):780-9.doi: 10.1007/s11096-013-9806-8.

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