Table 1.
Summary of studies assessing medication adherence in a chronic kidney disease patient population
| Study, N | Differential Diagnoses Assessed | Adherence Definition | Average # of Meds | Mean Age (years) | Mean eGFRa | Adherence Assessment | Limitations |
|---|---|---|---|---|---|---|---|
| Assessment Type: Self-Report Questionnaire | |||||||
| Parker et. al 2019 [26] N = 157 |
Medication complexity | MMAS-8, scored 0-8. Low: <6 Medium: 6-7 High: 8 |
16 | 76 | < 15b | Low: 17% Med: 28% |
Self-reported adherence in those aged 65+ years with CKD 5 |
| Ghimire et. al 2016 [28] N = 53 |
Medication complexity | MMAS-4, scored 0-4 0: Adherent |
11 | 68 | ESRD | Nonadherent: 57% | Self-reported adherence in those with ESRD |
| Tangkiatkumjai et. al 2017 [19] N = 295 |
Cognitive impairment, Low health literacy | MMAS-8 Low: <6 Moderate-to-high: 6-8 |
11 | 68 | 39 | Low: 21% Med-High: 79% |
Self-reported adherence in patients living in Thailand |
| Muntner et. al 2010 [23] N = 3936 |
Cognitive impairment, Systems-based barriers | MMAS-4 Low: 2-4 Medium: 1 High: 0 |
N/A | 69 | 65 | Low: 31% | Self-reported adherence in a single study visit |
| Cedillo-Couvery et. al 2018 [18] N = 3305 |
Low health literacy | Based on 3 questions, missed or added doses in last week. Low: >1 purposefully Medium: >1 accidentally |
9 | 59 | 42 | Low: 15% Med: 17% |
Self-reported adherence |
| Hsu et. al 2015 [24] N = 293 |
Low health literacy, Systems-based barriers | Based on 3 questions, missed or added doses in last month. | 12 | 66 | N/A | Low: 53% | Self-reported adherence |
| Sontakke et. al 2015 [25] N = 150 |
Systems-based barriers, Low health literacy, Cognitive impairment | 8 questions about medication habits, compared to MMAS-8 | 8 | 51 | N/A | Nonadherent: 34% | Self-reported adherence |
| Hong et. al 2016 [27] N = 981 |
None | 6 questions about medication adherence plus pill count Perfect: 100% Moderately high: 75-99% Moderately low: 50-74% Low: <50% |
N/A | 55 | N/A | Low: 24% Med-Low: 22% |
Self-reported adherence to antihypertensives only in African-American patients |
| Assessment Type: Interview | |||||||
| Rifkin et. al 2010 [7] N = 20 |
Cognitive impairment, Low health literacy | 40-minute interview | 8 | 72 | N/Ac | N/A | Self-reported adherence in a small sample from a single US institution |
| Wang et. al 2019 [32] N = 449 |
None | Utilized the CKD self-care scale, 5 questions address adherence | N/A | 64 | 41 | Mean adherence score: 22.92/25 | Focused on self-care, not adherence, in Taiwanese patients |
eGFR = estimated glomerular filtration rate, MMAS-8 = 8-item Morisky Medication Adherence Scale, CKD = chronic kidney disease, ESRD = end-stage renal disease, MMAS-4 = 4-item Morisky Medication Adherence Scale, N/A = not applicable, US = United States
a)
eGFR measured in mL/min/1.73m2
b)
Included those with eGFR < 15 mL/min/1.73m2 only
c)
Twelve participants had CKD stage 3-5; eight participants had ESRD on dialysis