Impact of Intensified Pharmaceutical Interventions in Medication Adherence in Chronic Kidney Disease Patients

Aim: The study aims to evaluate the medication adherence behavior of individuals by using validated questionnaire and to enhance the adherence by using various cost effective interventional methods which likely have a greater effect on the health of patients with chronic diseases than any Improvement in specific medical therapies. Method: The prospective interventional study was carried out for a period one year. The participants selected from the outpatients of nephrology department in a 750-bedded tertiary care hospital in the Malabar region of south India. Patients were provided with a standard validated modified Morisky eight item questionnaire and self-reporting questionnaire assessing medication adherence before and after intervention. The intervention mainly in the form of patient counseling and patient information leaflet was carried out using a proper management plan and with the help of physician and feedback information was collected. Results: Statistically significant association exist between medication adherence before and after intervention (p <0.001). Medication adherence behavior of study subjects has a significant association with age, sex, education and stage of chronic kidney disease. Pharmaceutical interventions impart a significant improvement in the medication adherence behavior. Cost of the treatment, low family income and drug therapy burden have been reported as a main reason for non-adherence. Individual patients have their own preferences for dosage form, frequency of administration, food time etc. Conclusion: The study suggests that the periodic counseling by clinical pharmacist at regular intervals can improve the medication adherence by improving awareness and removing the misconceptions about the disease and therapy.