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International Journal of Clinical Pharmacy

, Volume 40, Issue 1, pp 26–35 | Cite as

Renal pharmacists’ perceptions and current practices of assessing medication adherence in dialysis patients

  • Saurav Ghimire
  • Colin Banks
  • Matthew D. Jose
  • Ronald L. Castelino
  • Syed Tabish R. ZaidiEmail author
Research Article
First Online:

Abstract

Background Medication nonadherence is a major problem in chronic kidney failure patients undergoing dialysis. Pharmacists play a vital role in improving medication-related patient outcomes, reducing drug-related problems, and improving medication adherence. However, little is known about how pharmacists assess medication adherence in dialysis patients. Objective To measure pharmacists’ perceptions, current practices, and barriers to assessing adherence in dialysis patients. Setting Australian renal-specialised pharmacists. Method An online survey was conducted between March and May 2016. Survey included five psychometric scales measuring perceived prevalence, contributors, effective methods, barriers, and confidence to assess adherence on a 10-point Likert scale (1 = strongly disagree; 10 = strongly agree). Current practices were identified using a 4-point graded response (1 = do not practice; 4 = practice for all). Main outcome measure: Perception scores, scale reliability, and responses to current practices questionnaire. Results 41 pharmacists completed the survey (response rate, 91.1%). The majority (91.9%, n = 34; median = 8.0) agreed patients were nonadherent to medication. Time constraints (43.8%, n = 14) and hospital support (31.3%, n = 10) were perceived as barriers to assessment. Objective blood monitoring was frequently used to determine nonadherence (57.1%, n = 16), whereas subjective interviews were rarely conducted (27.6%, n = 8). Though all pharmacists support the presence of dedicated pharmacist for assessing adherence (100.0%, n = 33), only 24.2% were actually performing this function. Conclusion Pharmacists were rarely assigned for adherence assessment in dialysis settings. Established self-report methods were under-utilised compared to objective methods. Future research should investigate the effectiveness of pharmacists’ involvement in facilitating adherence promotion and early identification of medication-related issues in dialysis patients.

Keywords

Australia Dialysis Kidney failure, chronic Medication adherence Renal pharmacists 
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Notes

Acknowledgements

The authors thank all the pharmacists for their participation in this study. Sincere thanks goes to Society of Hospital Pharmacists of Australia (SHPA) for their support during the conduct of the study. Also, a sincere gratitude goes to Division of Pharmacy, University of Tasmania for providing pre-paid gift vouchers for the survey participants.

Funding

None.

Conflicts of Interest

None.

Supplementary material

11096_2017_574_MOESM1_ESM.docx (73 kb)
Supplementary material 1 (DOCX 73 kb)

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2017

Authors and Affiliations

  • Saurav Ghimire
    • 1
  • Colin Banks
    • 2
  • Matthew D. Jose
    • 2
    • 3
  • Ronald L. Castelino
    • 1
    • 4
    • 5
  • Syed Tabish R. Zaidi
    • 1
    Email author
  1. 1.Unit for Medication Outcomes Research and Education (UMORE), Pharmacy, School of Medicine, Faculty of HealthUniversity of TasmaniaHobartAustralia
  2. 2.Department of NephrologyRoyal Hobart HospitalHobartAustralia
  3. 3.School of Medicine, Faculty of HealthUniversity of TasmaniaHobartAustralia
  4. 4.Sydney Nursing SchoolThe University of SydneySydneyAustralia
  5. 5.Blacktown HospitalWestern Sydney Local Health DistrictSydneyAustralia

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