Presentation (CTI)

OBJECTIVES: This study aims to investigate the factors related to medication adherence and non-adherence, as well as patients' perspectives on their medication-taking behavior.
METHODS: A semi-structured qualitative study was conducted among 39 dialysis patients from January to April 2024 at the dialysis unit of the Pakistan Institute of Medical Sciences, Islamabad, Pakistan. Data were collected through in-depth interviews. Purposive sampling was used to recruit participants for individual interviews. The interviews were conducted in Urdu (the local language), transcribed verbatim, and translated into English. Interviews were audiotaped, checked, and analyzed using inductive thematic analysis.
RESULTS: Thirty-nine hemodialysis patients (mean age: 45.2 ± 9.6 years) participated, with the majority being male (56.4%), married (76.9%), and having a secondary education (38.5%). Their mean illness duration was 6.15 ± 3.67 years, with an average daily pill count of 9.28 ± 4.67. Furthermore, 51.3% have 2-3 comorbidities, and most (94.9%) underwent dialysis twice weekly. Barriers to adherence included mistrust in medical advice, forgetfulness, high medication costs, complex regimens, side effects, inadequate patient-provider communication, and medication unavailability. In contrast, facilitators included trust in healthcare providers, perceived benefits of medication, routine integration, external motivation, reminders, and social support.
CONCLUSIONS: Medication nonadherence among hemodialysis patients was primarily driven by patient-related and medication-specific challenges. The findings of this study provide valuable insights for policymakers, researchers, and healthcare professionals in the development and evaluation of interventions designed to improve adherence among patients undergoing dialysis. For instance, the involvement of pharmacists in medication reconciliation, counseling, and adherence reviews could improve treatment outcomes. Future research should focus on exploring the perspectives of healthcare providers to develop targeted interventions for improved adherence.