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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Carlo Alfieri, Anna Regalia, Francesca Zanoni, Simone Vettoretti, Mario Cozzolino, Piergiorgio Messa
Secondary hyperparathyroidism (SHPT) is a frequent condition in the presence of chronic kidney disease (CKD). In CKD patients, SHPT is reported to increase both morbidity and mortality, especially cardiovascular. The difficulty in the treatment of SHPT in clinical practice is frequently encountered from a not always adequate conduct of the clinicians and a common non-compliance to the therapy of CKD patients. In this review, the greatest difficulties from clinicians and CKD-patients' point of view in the treatment of SHPT will be addressed, with particular attention to those related to dialysis features, nutritional habits, and medical therapy...
September 17, 2018: Blood Purification
Geldine Chironda, Busisiwe Rosemary Bhengu
The integrated management of chronic kidney disease (CKD) demands significant changes, as patients need to adhere to dialysis, medication, and dietary and fluid restrictions. Therefore, there is a need to identify the motivators of adherence to improve the quality of life of these patients. The aim of the present study was to explore the motivators of adherence to integrated management among patients with CKD in South Africa. A phenomenological design was used. A sample size of 12 participants was selected according to data saturation...
September 7, 2018: Nursing & Health Sciences
A Jakubowska-Winecka, M Biernacka
The objective of the study was to determine the connection between parental attitudes and medication adherence and the selected aspects of treatment in groups of adolescents after kidney and liver transplantations, in comparison with adolescents with diabetes and inflammatory bowel disease. Attitudes were assessed using M. Plopa's Parental Attitudes Scale, which distinguishes 5 types of attitudes. Medication adherence was evaluated on the basis of the Morisky Medication Adherence Scale (MMAS-8), used with the author's consent...
September 2018: Transplantation Proceedings
Catherine M Sullivan, Kitty V Barnswell, Kate Greenway, Cindy M Kamps, Derrick Wilson, Jeffrey M Albert, Jacqueline Dolata, Anne Huml, Julie A Pencak, John T Ducker, Roberto Gedaly, Christopher M Jones, Todd Pesavento, Ashwini R Sehgal
BACKGROUND AND OBJECTIVES: Many patients with ESKD face barriers in completing the steps required to obtain a transplant. These eight sequential steps are medical suitability, interest in transplant, referral to a transplant center, first visit to center, transplant workup, successful candidate, waiting list or identify living donor, and receive transplant. This study sought to determine the effect of navigators on helping patients complete these steps. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Our study was a cluster randomized, controlled trial involving 40 hemodialysis facilities and four transplant centers in Ohio, Kentucky, and Indiana from January 1, 2014 to December 31, 2016...
August 22, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Shu-Li Wang, Yi-Wen Chiu, Lan-Fang Kung, Tzu-Hui Chen, Shih-Ming Hsiao, Pei-Ni Hsiao, Shang-Jyh Hwang, Hui-Min Hsieh
AIM: Self-care behavior represents the "action" element of self-management. This study aimed to use the Chronic Kidney Disease Self-Care (CKDSC) scale to examine factors associated with self-care and aspects of self-care deficits among patients with CKD stages in Taiwan. METHODS: A cross-sectional investigation was conducted using the CKDSC scale with a total of 449 CKD patients in Taiwan. The CKDSC is a 16-item questionnaire with five subscales, including medication adherence, diet control, exercise, smoking behaviors, and blood pressure monitoring...
August 20, 2018: Nephrology
Cozumel S Pruette, Shayna S Coburn, Cyd K Eaton, Tammy M Brady, Shamir Tuchman, Susan Mendley, Barbara A Fivush, Michelle N Eakin, Kristin A Riekert
BACKGROUND: Medical provider assessment of nonadherence is known to be inaccurate. Researchers have suggested using a multimethod assessment approach; however, no study has demonstrated how to integrate different measures to improve accuracy. This study aimed to determine if using additional measures improves the accurate identification of nonadherence beyond provider assessment alone. METHODS: Eighty-seven adolescents and young adults (AYAs), age 11-19 years, with chronic kidney disease (CKD) [stage 1-5/end-stage renal disease (ESRD)] and prescribed antihypertensive medication, their caregivers, and 17 medical providers participated in the multisite study...
August 16, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Kunal Yadav, David M Vock, Arthur J Matas, William N Robiner, Thomas E Nevins
Background: Nonadherence to posttransplant immunosuppressive medication is associated with increased rates of rejection and graft loss, yet it is unknown to what degree ideal adherence is associated with the sequelae of overimmunosuppression. Specifically, we questioned whether excellent adherence increased the posttransplant cancer risk. Methods: Between August 1998 and August 2006, 195 consenting kidney transplant recipients had electronic monitoring of theirimmunosuppressive medication adherence...
August 8, 2018: Nephrology, Dialysis, Transplantation
Trine Mechta Nielsen, Metha Frøjk Juhl, Bo Feldt-Rasmussen, Thordis Thomsen
Non-adherence to multipharmacological treatment increases the risk of morbidity, mortality and hospitalization. We know little about the perspective of patients with chronic kidney disease regarding factors influencing medicine taking. This study aimed to synthesize findings from qualitative studies of patients' experiences of factors that facilitate and hinder adherence to medication. A systematic review of qualitative studies adhering to the Enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) framework...
August 2018: Clinical Kidney Journal
Niteesh K Choudhry, Thomas Isaac, Julie C Lauffenburger, Chandrasekar Gopalakrishnan, Marianne Lee, Amy Vachon, Tanya L Iliadis, Whitney Hollands, Sandra Elman, Jacqueline M Kraft, Samrah Naseem, Scott Doheny, Jessica Lee, Julie Barberio, Lajja Patel, Nazleen F Khan, Joshua J Gagne, Cynthia A Jackevicius, Michael A Fischer, Daniel H Solomon, Thomas D Sequist
Importance: Approximately half of patients with chronic conditions are nonadherent to prescribed medications, and interventions have been only modestly effective. Objective: To evaluate the effect of a remotely delivered multicomponent behaviorally tailored intervention on adherence to medications for hyperlipidemia, hypertension, and diabetes. Design, Setting, and Participants: Two-arm pragmatic cluster randomized controlled trial at a multispecialty group practice including participants 18 to 85 years old with suboptimal hyperlipidemia, hypertension, or diabetes disease control, and who were nonadherent to prescribed medications for these conditions...
September 1, 2018: JAMA Internal Medicine
Karen K Wong, Alexandra Velasquez, Neil R Powe, Delphine S Tuot
BACKGROUND: We explored the association between health literacy and self-care behaviors among low-income patients with chronic kidney disease (CKD). METHODS: We used baseline data from the Kidney Awareness Registry and Education trial (n = 137 patients with CKD) and multivariable logistic regressions to cross-sectionally examine the association between health literacy, defined by a validated questionnaire, and healthy behaviors. RESULTS: Study participants had a mean age of 55 years, were racially diverse (6% White, 36% Hispanic, 43% Black, 15% Asian) and 26% had low health literacy...
August 6, 2018: BMC Nephrology
I Woźniak, A Kolonko, J Chudek, Ł Nowak, M Farnik, A Więcek
BACKGROUND: Kidney transplant recipients are frequently treated for other medical conditions and experience polypharmacy. The aim of our study was to evaluate quality of life in relation to medicines' burden in these patients. METHODS: We studied 136 unselected patients with mean post-transplant time of 7.2 ± 4.6 years. Quality of life was evaluated using a validated Polish version of the Kidney Disease Quality of Life-Short Form questionnaire. Data concerning the type (generic name) and number of currently prescribed medications were collected by interview survey...
July 2018: Transplantation Proceedings
Angela Q Maldonado, Patricia West-Thielke, Mary Amanda Dew, John Devin Peipert, Seth Heldenbrand, Tiffany E Kaiser, Marie Chisholm-Burns, Lisa M Potter
Despite advances in the field of transplantation, immunosuppressant medication nonadherence (NA) remains a primary contributor to suboptimal long-term outcomes. Due to the multidimensional and multifactorial causes of medication NA, studies to date have focused on individual differing facets or single point barriers of NA with relative success. However, these successes have not proven to be sustainable, partly due to the intense resources needed for continued viability. This article provides a summary of a 2-day meeting held in April 2017 (Chicago, IL) prior to the American Transplant Congress in which a multidisciplinary group convened to identify the unmet research needs related to medication NA in transplantation...
July 27, 2018: Clinical Transplantation
Yuki Tamaura, Masaaki Nishitani, Rie Akamatsu, Nobuyo Tsunoda, Fumiko Iwasawa, Keiko Fujiwara, Takuya Kinoshita, Masashi Sakai, Toru Sakai
OBJECTIVE: This study aimed to identify dietary and fluid behaviors associated with relative interdialytic weight gain (RIDWG) (divided by the respective dry weight [DW]) by stratifying the patients according to body mass index (BMI). DESIGN AND METHODS: This was a cross-sectional, multicenter investigation. Between July 2016 and March 2017, data were collected from 4 Japanese dialysis centers in 3 cities. The patients (n = 577) were asked to reply to a self-completed questionnaire, including questions on perception about DW and dietary and fluid behaviors...
July 17, 2018: Journal of Renal Nutrition
Larissa Myaskovsky, Michelle T Jesse, Kristin Kuntz, Abbie D Leino, John Devin Peipert, Cynthia L Russell, Christina A Spivey, Nimisha Sulejmani, Mary Amanda Dew
Starting in 2015, the American Society of Transplantation Psychosocial Community of Practice, with representatives of the Transplant Pharmacy Community of Practice, convened a taskforce to develop a white paper that focused on clinically practical, evidenced-based interventions that transplant centers could implement to increase adherence to medication and behavioral recommendations in adult solid organ transplant recipients. The group focused on what centers could do in their daily routines to implement best practices to increase adherence in adult transplant recipients...
July 19, 2018: Clinical Transplantation
Ebele M Umeukeje, Amanda S Mixon, Kerri L Cavanaugh
Objectives: This review summarizes factors relevant for adherence to phosphate-control strategies in dialysis patients, and discusses interventions to overcome related challenges. Methods: A literature search including the terms "phosphorus", "phosphorus control", "hemo-dialysis", "phosphate binder medications", "phosphorus diet", "adherence", and "nonadherence" was undertaken using PubMed, PsycInfo, CINAHL, and Embase...
2018: Patient Preference and Adherence
Nesa Noghan, Arash Akaberi, Sepideh Pournamdarian, Elham Borujerdi, Sima Sadat Hejazi
Background: The relationship between resilience, one of the important issues in mental health, and therapeutic regimen compliance, the key in the successful management of chronic disease such as chronic kidney disease, is unclear. Objective: The aim of this study was to determine the relationship between resilience and therapeutic regimen compliance in ESRD patients, undergoing hemodialysis. Methods: In this cross-sectional study, 107 hemodialysis patients referred to Besat and Shahid Beheshti Hospitals of Hamedan, Iran were selected through systematic sampling method from January to April 2013...
May 2018: Electronic Physician
Julie Boucquemont, Ahna Lh Pai, Vikas R Dharnidharka, Diane Hebert, Susan L Furth, Bethany J Foster
BACKGROUND: Among kidney transplant recipients, gender differences in medication adherence may contribute to the higher graft failure risks observed in girls and young women compared with boys and young men. Our aim was to determine whether adherence differs by gender, and whether gender differences vary by age in adolescent and young adult kidney transplant recipients. METHODS: We examined data from the 3-month run-in period (no intervention) of the randomized TAKE-IT trial...
July 9, 2018: Transplantation
Mark Beyebach, María Del Carmen Neipp, Maite García-Moreno, Inés González-Sánchez
AIM: To test the hypothesis that fluid adherence in patients on haemodialysis can be improved through nurses' solution-focused communication with patients on issues of adherence. BACKGROUND: Adherence to fluid-intake restrictions is low in patients on haemodialysis, creating serious health risks. Psychosocial interventions to increase adherence have typically focused on patients and ignored patient/staff interactions. DESIGN: This is a single-group, pre-post pilot study registered in ClinicalTrials...
July 10, 2018: Journal of Advanced Nursing
J D Gatwood, M Chisholm-Burns, R Davis, F Thomas, P Potukuchi, A Hung, C P Kovesdy
AIM: To determine the association of adherence to oral antidiabetes medication with macrovascular and microvascular complications, time to insulin therapy, revascularization, admissions, and death among veterans with uncomplicated diabetes. METHODS: This was a retrospective cohort study using the Veterans Affairs Corporate Data Warehouse to examine 159 032 veterans diagnosed with uncomplicated diabetes during 2002-2014 and starting oral antidiabetes therapy for the first time...
July 6, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Hiroyuki Nagasawa, Tomoya Tachi, Ikuto Sugita, Hiroki Esaki, Aki Yoshida, Yuta Kanematsu, Yoshihiro Noguchi, Yukio Kobayashi, Etsuko Ichikawa, Teruo Tsuchiya, Hitomi Teramachi
Dialysis treatment is known to lead to reduced quality of life (QOL) among patients. This decreased QOL is believed to influence medication compliance, although this effect has not yet been clarified. In this study, we investigated whether decreased QOL due to dialysis treatment does in fact influence medication compliance. Participants were 92 patients who self-managed their medication and were receiving dialysis treatment at Secomedic Hospital or Chiba Central Medical Center. We surveyed their age, sex, dialysis period, and medication management situation, and administered the EQ-5D and Kidney Disease Quality of Life Instrument-Short Form...
2018: Frontiers in Pharmacology
2018-06-30 08:45:16
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