Nonadherence in Dialysis Patients: Prevalence, Measurement, Outcome, and Psychological Determinants
Open accessAbstract
Nonadherence to aspects of the management of End‐Stage Kidney Disease (ESKD) is common. Estimates of nonadherence vary with assessment method. Whilst readily available and free from report bias, physiological proxies—frequently used as measures of adherence—are often confounded by clinical factors including residual kidney function and dialysis adequacy. Despite variation in estimates of its prevalence, it is clear that suboptimal adherence to dialysis prescriptions, medication and diet can lead to adverse clinical outcomes. Several factors can help explain nonadherence in ESKD including mood, self‐efficacy, social support, illness, and treatment perceptions. Psychological interventions have been shown to improve ESKD adherence, yet achieving long‐term behavior change remains challenging. Identifying individuals who struggle to adhere to aspects of the dialysis regime, and tailoring theory‐led interventions to improve and support adherence is a clear clinical need requiring further empirical enquiry.
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Associations between non-adherence to ESKD self-management behaviours and elevated symptoms of depression are consistently reported.
“Associations between non-adherence to ESKD self-management behaviours (e.g. skipping and/or shortening dialysis treatments, following diet and fluid restrictions) and elevated symptoms of depression are consistently reported (Clark et al . 2014).”
From Improving Distress in Dialysis (iDiD): A tailored CBT self-management treatment for patients undergoing dialysis. (2016) · cites this paper as Clark et al . 2014
The Abstract says that mood can help explain nonadherence in ESKD and identifies dialysis prescriptions and diet as aspects of adherence. It does not specifically say that elevated depressive symptoms are consistently associated with skipping or shortening dialysis or with failure to follow diet and fluid restrictions. (LLM, conf=0.76)
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DiMatteo, M. R. (2004) · Medical Care · doi:10.1097/01.mlr.0000114908.90348.f9 · Cited by 2,169 · see citing works
Cochrane, G. M., Horne, R., & Chanez, P. (1999) · Respiratory Medicine · doi:10.1016/s0954-6111(99)90260-3 · Cited by 246 · see citing works
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Social Determinants of Racial Disparities in CKD
Norton, J. M., Moxey-Mims, M. M., Eggers, P. W., Narva, A. S., Star, R. A., Kimmel, P. L., & Rodgers, G. P. (2016) · Journal of the American Society of Nephrology · doi:10.1681/asn.2016010027 · Cited by 345 · see citing works
Hudson, J. L., Moss‐Morris, R., Game, D., Carroll, A., & Chilcot, J. (2016) · Journal of Renal Care · doi:10.1111/jorc.12168 · Cited by 80 · see citing works
Self-citation
- Authors
- Clark, S., Farrington, K., & Chilcot, J.
- Affiliations
- University of Leeds (GB)
- Lister Hospital (GB)
- King's College London (GB)
- Corresponding author
- Chilcot, Joseph
- Venue
- Seminars in Dialysis
- Publisher
- Wiley
- Published
- 2013-10-25
- Volume
- 27
- Issue
- 1
- Pages
- 42-49
- ISSN
- 0894-0959 (ISSN-L)
- 1525-139X
- OpenAlex
- W2134878336
- Cited by
- 134
- References
- 2
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 7 · 2023: 9 · 2022: 7 · 2021: 6 · 2020: 19 · 2019: 16 · 2018: 12 · 2017: 10 · 2016: 23 · 2015: 8 · 2014: 5
- FWCI
- 1.66
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Licence
- Locations
- Seminars in Dialysis (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (publishedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- non-compliance, end-stage renal disease, dialysis, medication adherence, dietary adherence, adherence measurement, residual renal function, dialysis adequacy, psychological factors, self-efficacy, social support, treatment perceptions, mood, psychological intervention, behavior change, clinical outcomes
- MeSH terms
- Attitude to Health, Depression, Renal Dialysis, Humans, Kidney Failure, Chronic, Health Knowledge, Attitudes, Practice, Patient Compliance, Surveys and Questionnaires, Social Support, Biomarkers, Health Behavior, Prevalence, Self Efficacy, Self Report
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