Evidence map›Paper›PMID 33559850›Full record

ReviewJournal of nephrology2021

Medication non-adherence in chronic kidney disease: a mixed-methods review and synthesis using the theoretical domains framework and the behavioural change wheel.

Wubshet H Tesfaye, Daniel Erku, Alemayehu Mekonnen, Yonas Getaye Tefera, Ronald Castelino, Kamal Sud, Jackson Thomas, Kehinde Obamiro

Abstract readReview
PubMed Publisher
In one paragraph

Review in Journal of nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 1 pooled it
7.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.

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  20. Mediation effect of self-neglect in family resilience and medication adherence in older patients undergoing maintenance hemodialysis.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 2 countries.

Wubshet H TesfayeHealth Research Institute, University of Canberra, Bruce, Canberra, Australian Capital Territory, Australia. Wubshet.Tesfaye@canberra.edu.au.ORCID 0000-0001-7208-2330
Daniel ErkuCentre for Applied Health Economics; Centre for Applied Health Economics, School of Medicine & Menzies Health Institute, Griffith University, Gold Coast, Australia.
Alemayehu MekonnenSchool of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Melbourne, Australia.
Yonas Getaye TeferaSchoool of Pharmacy, University of Gondar, Gondar, Ethiopia.
Ronald CastelinoSydney Nursing School, University of Sydney, Sydney, Australia.
Kamal SudMedicine, Nepean Clinical School, University of Sydney, Sydney, Australia.
Jackson ThomasFaculty of Health, University of Canberra, Canberra, Australia.
Kehinde ObamiroCentre for Rural Health, University of Tasmania, Launceston, Australia.
The University of Sydney · AUUniversity of Canberra · AUDeakin University · AUGriffith University · AUUniversity of Gondar · ETUniversity of Tasmania · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveMedication non-adherence is a well-recognised issue in chronic diseases but data in patients with chronic kidney disease (CKD) not receiving kidney replacement therapy (KRT) remains limited. This review summarised the prevalence of medication non-adherence and assessed determinants and outcomes associated with it in adults with CKD, not on KRT.

methodWe searched PubMed, Embase, PsychInfo, Web of Science, and Cochrane (CENTRAL) for studies published until January 2020. Pooled prevalence of medication non-adherence was reported. Determinants of adherence-identified from quantitative and qualitative studies-were mapped into the theoretical domains framework and interventions proposed using the behavioural change wheel.

resultsTwenty-seven studies (22 quantitative and 5 qualitative) were included. The pooled prevalence of medication non-adherence was 39% (95% CI 30-48%). Nine studies reported association between non-adherence and outcomes, including blood pressure, disease progression, adverse events, and mortality. Modifiable determinants of non-adherence were mapped into 11 of the 14 Theoretical Domains Framework-of which, six appeared most relevant. Non-adherence decisions were usually due to lack of knowledge on CKD, comorbidities, and medications; polypharmacy and occurrence of medication side effects; changes in established routines such as frequent medication changes; higher medication cost, poor accessibility to medications, services and facilities; inadequate patient-healthcare professional communication; and forgetfulness. Using the behavioural change wheel, we identified several areas where interventions can be directed to improve medication adherence.

conclusionMedication non-adherence is common in adults with CKD, not on KRT and may lead to poor outcomes. Evidence synthesis using mixed study designs was crucial in identifying determinants of non-adherence, drawing on a parsimonious approach from behaviour science. PROSPERO REGISTRATION: CRD42020149983.

Indexed as

Medication AdherenceRenal Insufficiency, ChronicAdultChronic DiseaseComorbidityHumansBehavioural change wheelChronic kidney diseaseMedication adherenceReviewTheoretical domains framework

Identifiers

PMID33559850
OpenAlexW3126424420

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.