Medication adherence among hemodialysis patients: the impact of pharmacist-led motivational interviewing

Abstract

Background: Significant proportion of haemodialysis (HD) patients fails to comply with their prescribed medication regimens, leading to poor health outcomes and survival rates. This highlights the need for interventions that improve medication adherence thereby leading to improved patient outcomes. Objectives: To evaluate the impact of motivational interviewing, a skilful clinical method to improve medication adherence among HD patients. Methods: A pre-post study was conducted prospectively among 63 HD patients at multicentre dialysis units. The recruited patients received three sessions of MI which helps in addressing patient beliefs around medication and overcome barriers for nonadherence. General medication adherence scale (GMAS) was used to evaluate the medication adherence among enrolled patients. An independent t-test was used to analyze the impact of MI in improving adherence among HD patients. In this study, the level of significance was 0.05. Results: A total of 63 patients (27 males and 36 females; mean age 48.5±13.9 years) were included in the study. While the mean of dialysis duration and number of medications was 7.7±6.0 years and 8.1±2.2 respectively. Paired t-test showed a significant increase in medication adherence score from a baseline for nonadherence domain of patient’s attitude and nonadherence domain of additional illness and pill overload at the end of the study (p<0.05). However, the non-adherence domain of financial constraints, was not statistically significant, p=0.507. Motivational interviewing was effective in increasing intrinsic positive attitude by resolving their ambivalence thus improving the adherence towards medication. Conclusion: This study emphasized that MI conducted by pharmacist effectively improves HD patients’ medication adherence. Healthcare professionals ought to employ this strategy in order to assist HD patients in better taking their medications.