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Cited by 111Medication Adherence and CompliancePharmacy and Medical PracticesDialysis and Renal Disease Management

Adherence to medication in patients with chronic kidney disease: A systematic review of qualitative research

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Mechta Nielsen, Trine, Frøjk Juhl, Metha, Feldt-Rasmussen, Bo, Thomsen, Thordis·2018·Clinical Kidney Journal
DOI 10.1093/ckj/sfx140PMC PMC6070096
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Abstract

Non-adherence to multipharmacological treatment increases the risk of morbidity, mortality and hospitalization. We know little about the perspective of patients with chronic kidney disease regarding factors influencing medicine taking. This study aimed to synthesize findings from qualitative studies of patients' experiences of factors that facilitate and hinder adherence to medication. A systematic review of qualitative studies adhering to the Enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) framework. Systematic searches were conducted in several databases. We used thematic synthesis and the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) approach to assess the confidence of the evidence. Nineteen studies involving 381 patients with chronic kidney disease were included. We identified three analytical themes; logistics, benchmarking the need for medication; and the quality of the patient-physician relationship, with seven descriptive sub-themes as factors influencing patients' adherence to medications. Helping patients to map their everyday activities and motivating them to associate medications with everyday activities may facilitate adherence to medications. Addressing patient beliefs about medications, supporting patients in coping with side effects of medications and eliciting patients' wishes for involvement in treatment decisions may also facilitate adherence. Barriers to adherence were the costs of buying medications, and lacking understanding of the indications and effects of medications. The findings in this synthesis resonate with previous research and extend the known literature by synthesizing and formally assessing confidence in the evidence.

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Authors
Mechta Nielsen, T., Frøjk Juhl, M., Feldt-Rasmussen, B., & Thomsen, T.
Affiliations
  • Department of Nephrology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
  • Department of Nephrology, University of Copenhagen, Rigshospitalet Copenhagen, Denmark
  • University of Copenhagen (DK)
ORCID
Thomsen, Thordis
Venue
Clinical Kidney Journal
Publisher
Oxford University Press (OUP)
Published
2017-12-25
Volume
11
Issue
4
Pages
513-527
ISSN
  • 2048-8505 (ISSN-L)
  • 2048-8513
DOI
10.1093/ckj/sfx140
PMC
PMC6070096
OpenAlex
W2777349545
Cited by
111
References
6
Citations by year
2026: 14 · 2025: 10 · 2024: 9 · 2023: 23 · 2022: 15 · 2021: 21 · 2020: 10 · 2019: 8 · 2018: 1
FWCI
0.87
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Kidney Journal (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
Funders
  • Abdominal Centre, Rigshospitalet
  • Copenhagen University Hospital
Topics
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
  • Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
Keywords
medication adherence, chronic kidney disease, patient perspectives, physician-patient relationship, adverse drug reactions, drug costs, medication beliefs, shared decision-making, barriers to adherence

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