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NSG2NCI Nursing Patients With Chronic Illness

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Question:

Medication Adherence Barriers in Patients with Chronic Kidney Disease
 
In Chronic Kidney Disease (CKD) administration of proper medication adherence is very important component for effective disease management. Nonadherence to medications increases the risk of morbidity, mortality, adverse clinical outcomes, increased healthcare costs and hospitalization. In CKD patients, their multiple co-morbidities need to be controlled with pharmacological management (Esteban et al.2018).The significant role of medications is to slow down the progression of the disease and to monitor complications. In 2017 Trine and co-authors states that managing multiple medications and healthcare appointments, with several times of dialysis in a week, is a challenging task for CKD patients (Trine et al. 2017).
 
Main barriers to medication adherence are the cost of buying medications, lack of understanding and knowledge of medication indications and effects of medications (Trine et al. 2017). Trine et al (2017) identified three analytical themes for medication barriers which are logistics, bench marking the need for medication, quality of the patients and physician relationship
 
Logistics barriers are challenges of managing complex medication regimens, multiple prescriptions, healthcare appointments and cost of buying medications (Trine et al. 2017).
 
Inadequate prescription coverage, lack of transportation, cost of buying medications are also barrier to adherence. Financially burdened patients tried to make the supply of their medication last longer by skipping doses, taking lower doses of medicine than prescribed, and asking their doctor to prescribe double strength medications to reduce the cost of medications (Jean et al.2007) & (Trine et al. 2017).
 
Absence of effect from lay perceptive - Most of the patients prioritized medications that they produced noticeable effects which are pain relief, symptom relief .Previous experiences of effects and side effects causing patients to benchmark which medications are important and which should be omitted (Trine et al. 2017).
 
Lacking an understanding of medication indications and effect-Patients are unaware about why the medications were prescribed or how they worked, result in their ignorance of taking the medications. Quality of patient and physician relationship is very important for medication adherence. Some patients experienced insufficient time for discussing medications with physicians(Trine et al. 2017).Lack of information, insufficient information about the medications, side effects, effects and interactions cause medication non adherence (Trine et al. 2017).
 
Please describe the strategies for medication barrier.
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