Pattern of Anti-hypertensive Prescription and Adherence to Anti- Hypertensive Medications among Patients with Chronic Kidney Disease in A Tertiary Health Care Facility in Southern Nigeria
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Abstract
Background: Patients with chronic kidney disease (CKD) often need pharmacological management for the rest of their lives. However, given the intricacy of specific regimens that call for the administration of various dosages, forms and frequency, sustaining continuous adherence is especially difficult. The aim of this study was to determine the level of medication adherence and factors associated with medical adherence among CKD patients in University of Port Harcourt Teaching Hospital (UPTH).
Methods: The study was a descriptive cross-sectional study conducted among 241 CKD patients in the renal outpatient clinic of UPTH who were selected by systematic sampling. The data on the variables were obtained using a semi-structured questionnaire. The data was analyzed using SPSS version 25. Categorical and numerical variables were summarized accordingly. Chi-square test was used to assess associations, with p < 0.05 considered statistically significant.
Results: The result showed that 184 (76.3%) of the respondents take diuretics while 164(68%) and 110(45.6%) were on calcium channel and beta-blockers respectively. 169 (70.1%), 57(23.7%) had low and moderate adherence respectively while 15(6.2%) had high medication adherence. The factors associated with medication adherence were partners level of education p=0.005, average monthly income p=0.028, relationship status p=0.013, duration of diagnosis p<0.001 and family history of CKD P=0.034.
Conclusion: Diuretics and calcium channel blockers were the most frequently used anti-hypertensives. Medication adherence was comparatively low. Patient oriented management that takes into consideration patients' socioeconomic status, educational level, relationship status, family history of CKD, and duration of illness may improve adherence and treatment outcomes.
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References
1.Rivera E, Clark-Cutaia MN, Schrauben SJ, Townsend RR, Lash JP, Hannan M, et al. Treatment adherence in CKD and support from health care providers: a qualitative study. Kidney Med. 2022;4(11):100545.
2.Sood V, Braun M, Hogue S, Lieberman B, Copley-Merriman C. High burden and unmet patient needs in chronic kidney disease. Int J Nephrol Renov Dis. 2012;5:151-163.
3.Saran R, Robinson B, Abbott KC, Agodoa LYC, Bragg-Gresham J, Balkrishnan R, et al. US renal data system 2018 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis. 2019;73(3):A7-A8.
4.Sundström J, Bodegard J, Bollmann A, Vervloet MG, Mark PB, Karasik A, et al. Prevalence, outcomes, and cost of chronic kidney disease in a contemporary population of 2.4 million patients from 11 countries: the CaReMe CKD study. Lancet Reg Health Eur. 2022; 20:100438.
5.Olanrewaju TO, Aderibigbe A, Popoola AA, Braimoh KT, Buhari MO, Adedoyin OT, et al. Prevalence of chronic kidney disease and risk factors in North-Central Nigeria: a population-based survey. BMC Nephrol. 2020;21(1):467.
6.Ibitoba FA, Akpor OA, Akpor OB. Prevalence and risk factors of chronic kidney disease among commercial motorcyclists in Ado-Ekiti, Ekiti State, Nigeria. Sci Afr. 2022;16:e01136.
7.Okwuonu C, Chukwuonye I, Adejumo O, Agaba E, Ojogwu L. Prevalence of chronic kidney disease and its risk factors among adults in a semi-urban community of South-East Nigeria. Niger Postgrad Med J. 2017;24(2):81-87.
8.Ovwasa H, Aiwuyo HO, Okoye AO, Unuigbe E, Rajora N. Epidemiology trend of chronic kidney disease in a semi-urban tertiary hospital in Sub-Saharan Africa. Cureus. 2023;15(3):e36912.
9.Levin A, Stevens PE. Summary of KDIGO 2012 CKD guideline: behind the scenes, need for guidance, and a framework for moving forward. Kidney Int. 2014;85(1):49-61.
10.Molnar MZ, Gosmanova EO, Sumida K, Potukuchi PK, Lu JL, Jing J, et al. Predialysis cardiovascular disease medication adherence and mortality after transition to dialysis. Am J Kidney Dis. 2016;68(4):609-618.
11.Chang TI, Winkelmayer WC. Kidney disease and antihypertensive medication adherence: the need for improved measurement tools. Am J Kidney Dis. 2010;56(3):423-426.
12.Bidani AK, Griffin KA. Pathophysiology of hypertensive renal damage: implications for therapy. Hypertension. 2004;44(5):595-601.
13.Kestenbaum B, Rudser KD, de Boer IH, Peralta CA, Fried LF, Shlipak MG, et al. Differences in kidney function and incident hypertension: the multi-ethnic study of atherosclerosis. Ann Intern Med. 2008;148(7):501-508.
14.Muntner P, Anderson A, Charleston J, Chen Z, Ford V, Makos G, et al. Hypertension awareness, treatment, and control in adults with CKD: results from the chronic renal insufficiency cohort (CRIC) study. Am J Kidney Dis. 2010;55(3):441-451.
15.Pugh D, Gallacher PJ, Dhaun N. Management of hypertension in chronic kidney disease. Drugs. 2019;79(4):365-379.
16.Burnier M, Pruijm M, Wuerzner G, Santschi V. Drug adherence in chronic kidney diseases and dialysis. Nephrol Dial Transplant. 2015;30(1):39-44.
17.Mechta Nielsen T, Frøjk Juhl M, Feldt-Rasmussen B, Thomsen T. Adherence to medication in patients with chronic kidney disease: a systematic review of qualitative research. Clin Kidney J. 2018;11(4):513-527.
18.Braimoh R, Busari A, Akinyede A, Ogunsakin A, Olayemi S. Assessment of factors affecting treatment adherence in patients with chronic kidney disease in Nigeria: a survey from a tertiary health-care centre. Niger J Med. 2023;32(1):49-55.
19.Timothy E, Blessing A. Adherence to haemodialysis among chronic renal failure patients of a tertiary health facility, Benin City, Edo State. Borno Med J. 2021;18:1-10.
20.Tesfaye WH, McKercher C, Peterson GM, Castelino RL, Jose M, Zaidi STR, et al. Medication adherence, burden and health-related quality of life in adults with predialysis chronic kidney disease: a prospective cohort study. Int J Environ Res Public Health. 2020;17(1):371.
21.Briggs D, Eleki B, Wesley O, Ibifubara N, Ibinabo M, Michael P. Prevalence and risk factors of chronic kidney disease among nonclinical healthcare providers at Rivers State University Teaching Hospital, Port Harcourt, Nigeria. 2023; 6:20-30.
22.Cochran WG. Sampling techniques. 2nd ed. New York: John Wiley & Sons; 1977.
23.Rivera E, Clark-Cutaia MN, Schrauben SJ, Townsend RR, Lash JP, Hannan M, et al. Treatment adherence in CKD and support from health care providers: a qualitative study. Kidney Med. 2022;4(11):100545.
24.Clark-Cutaia MN, Rivera E, Iroegbu C, Squires A. Disparities in chronic kidney disease: the state of the evidence. Curr Opin Nephrol Hypertens. 2021;30(2):208-214.
25.Saran R, Robinson B, Abbott KC, Agodoa LYC, Bragg-Gresham J, Balkrishnan R, et al. US renal data system 2018 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis. 2019;73(3): A7-A8.
26.Levin A, Stevens PE. Summary of KDIGO 2012 CKD guideline: behind the scenes, need for guidance, and a framework for moving forward. Kidney Int. 2014;85(1):49-61.
27.Okoro RN, Ummate I, Ohieku JD, Yakubu SI, Adibe MO, Okonta MJ. Evaluation of medication adherence and predictors of sub-optimal adherence among pre-dialysis patients with chronic kidney disease. Med Access Point Care. 2020; 4:2399202620954089.
28.Legesse ES, Muhammed OS, Hamza L, Nasir BB, Nedi T. Medication-related problems among ambulatory patients with chronic kidney disease at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. PLoS One. 2022;17(12):e0278563.
29.Tesfaye WH, Erku D, Mekonnen A, Tefera YG, Castelino R, Sud K, et al. Medication non-adherence in chronic kidney disease: a mixed-methods review and synthesis using the theoretical domains framework and the behavioural change wheel. J Nephrol. 2021;34(4):1091-1125.
30.Hess S, De Geest S, Halter K, Dickenmann M, Denhaerynck K. Prevalence and correlates of selected alternative and complementary medicine in adult renal transplant patients. Clin Transplant. 2009;23(1):56-62.
31.Stanifer JW, Lunyera J, Boyd D, Karia F, Maro V, Omolo J, et al. Traditional medicine practices among community members with chronic kidney disease in northern Tanzania: an ethnomedical survey. BMC Nephrol. 2015;16(1):170.
32.Afolaranmi TO, Hassan ZI, Uwadiae EJ, Nwokolo UE, Nwaemelu IB, Ugwu KG, et al. Use of complementary and alternative medicine among patients on long-term treatment in a tertiary health institution in Jos, Nigeria. Int J Prev Med. 2022; 13:46.
33.Debelle FD, Vanherweghem JL, Nortier JL. Aristolochic acid nephropathy: a worldwide problem. Kidney Int. 2008;74(2):158-169.
34.Izzo AA, Ernst E. Interactions between herbal medicines and prescribed drugs: a systematic review. Drugs. 2009;69(13):1777-1798.
35.James PB, Taidy-Leigh L, Bah AJ, Kanu JS, Kangbai JB, Sevalie S. Prevalence and correlates of herbal medicine use among women seeking care for infertility in Freetown, Sierra Leone. Evid Based Complement Alternat Med. 2018; 2018:9493807.