Rates of Intentional and Unintentional Nonadherence to Peritoneal Dialysis Regimes and Associated Factors

PLoS One. 2016 Feb 26;11(2):e0149784. doi: 10.1371/journal.pone.0149784. eCollection 2016.

Abstract

With increasing emphasis on expanding home-based dialysis, there is a need to understand adherence outcomes. This study set out to examine the prevalence and predictors of nonadherence among patients undergoing peritoneal dialysis. A cross sectional sample of 201 peritoneal dialysis patients recruited between 2010-2011 from Singapore General Hospital completed measures of quality of life, medication beliefs, self-efficacy and emotional distress. Nonadherence rates were high; 18% for dialysis, 46% for medication and 78% for diet. Intentional nonadherence was more common for dialysis (p = .03), whereas unintentional nonadherence was more common for medication (p = .002). Multivariate models indicated significant associations for higher education (intermediate vs low OR = 3.18, high vs low OR = 4.70), lower environment quality of life (OR = 0.79), dialysis self-efficacy (OR = 0.80) with dialysis nonadherence; higher education (OR = 2.22), self-care peritoneal dialysis (OR = 3.10), perceived necessity vs concerns over medication (OR = 0.90), self-efficacy (OR = 0.76) with nonadherence to medication. The odds for nonadherence to diet were higher among patients who were younger (OR = 0.96), of Chinese ethnicity (OR = 2.99) and those reporting better physical health (OR = 1.30) and lower self-efficacy (OR = 0.49). Nonadherence is common in peritoneal dialysis. Self-efficacy and beliefs about medication are promising targets for interventions designed to improve adherence.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Intention*
  • Male
  • Middle Aged
  • Patient Compliance / psychology
  • Patient Compliance / statistics & numerical data*
  • Peritoneal Dialysis / psychology
  • Peritoneal Dialysis / statistics & numerical data*
  • Quality of Life / psychology*
  • Self Care / psychology
  • Self Efficacy*
  • Singapore
  • Stress, Psychological / psychology

Grants and funding

This research was supported by a grant from the National University of Singapore (NUS-Cross Faculty Research Grant - CFG11P3) awarded to Associate Professor KG and Professor SC, which is gratefully acknowledged. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.