Ghimire, S, Lee, K, Jose, MD et al. (2 more authors) (2019) Adherence assessment practices in haemodialysis settings: A qualitative exploration of nurses and pharmacists' perspectives. Journal of Clinical Nursing, 28 (11-12). pp. 2197-2205. ISSN 0962-1067
Abstract
Aims and objectives
To explore clinician assessment of patient adherence and identify strategies to improve adherence assessment practices in haemodialysis settings.
Background
Patients with chronic kidney disease undergoing haemodialysis are typically prescribed complex regimens; as such, they are at high risk of medication nonadherence. Current clinical practices focus on prescribing medications; however, little attention is paid to measuring and ensuring patient adherence to their prescribed treatments.
Design
A qualitative study.
Methods
Semi‐structured individual interviews were conducted in November and December 2016, with 12 nurses and 6 pharmacists, working in Australian haemodialysis settings. The study was conducted and reported in accordance with COREQ guidelines.
Results
Participants were 25–60 years old and had 1–27 years of experience in dialysis. Seven themes related to assessing adherence were identified: prioritisation of resources, interplay between workload and available time, awareness of formalised adherence measures and training deficits, concerns about practicality/suitability of adherence measures, communication of assessment services, patient participation and trust. Three themes related to strategies for improving adherence assessment practices were identified: formalisation of adherence assessment process, integration of assessment processes and tools into routine, and use of multidisciplinary support to assess and promote adherence.
Conclusions
Current adherence assessment practices could be improved through formalisation and integration of the assessment process into dialysis unit policy/procedures. Additionally, as barriers to assessing adherence were identified at organisational, professional and patient levels, there is a need to address barriers from each level in order to improve adherence assessment practices in haemodialysis settings.
Relevance to clinical practice
This qualitative study highlights the challenges and practical ways by which adherence assessment practices could be improved in haemodialysis settings. This would encourage renal clinicians to actively participate in adherence assessment and promotion activities to ensure patients benefit from their therapies.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2019 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Ghimire, S, Lee, K, Jose, MD et al. (2 more authors) (2019) Adherence assessment practices in haemodialysis settings: A qualitative exploration of nurses and pharmacists' perspectives. Journal of Clinical Nursing, 28 (11-12). pp. 2197-2205. ISSN 0962-1067, which has been published in final form at https://doi.org/10.1111/jocn.14821. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. |
Keywords: | adherence assessment practices; chronic; dialysis; haemodialysis; kidney failure; medication adherence; qualitative research |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Healthcare (Leeds) > Pharmacy (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 13 May 2019 10:50 |
Last Modified: | 20 Feb 2020 01:38 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1111/jocn.14821 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:145941 |