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Abstract: TH-PO314

Association of Psychosocial Factors with Adherence to Treatment Among Prevalent Dialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Ang, Joshua Benjamin, Emory University, Atlanta, Georgia, United States
  • Lea, Janice P., Emory University , Atlanta, Georgia, United States
  • Adisa, Olufunmilola, Emory School of Medicine , Buford, Georgia, United States
  • Sahlie, Abyalew, Emory University, Atlanta, Georgia, United States
  • Obadina, Catherine I., Emory University School of Medicine, Marietta, Georgia, United States
  • Plantinga, Laura, Emory University, Atlanta, Georgia, United States
Background

Dialysis patients are expected to adhere to dialysis treatments, medications, and dietary and fluid restrictions; these may be complicated by patient psychosocial issues. The aim of this study was to examine the relationship between social worker-assessed psychosocial factors and patients’ perceived ease of adherence to treatment among prevalent dialysis patients.

Methods

Data were extracted from the initial comprehensive assessment performed by social workers for patients starting dialysis treatment at three outpatient Emory Dialysis centers. Exposures were social worker-assessed psychosocial factors, primarily depression/anxiety. Outcome was patient-perceived ease of adherence across five categories: ability to come to dialysis, complete dialysis, take medications, follow dietary restrictions, and follow fluid restrictions. Responses were dichotomized as “easy” vs. “not easy.” Statistical analysis was performed using ANOVA, t test, and Pearson’s chi-square.

Results

Of 1334 patients, 205 (15.4%) were reported to have depression/anxiety. Compared to those without depression/anxiety, patients with depression/anxiety were significantly less likely to find adherence across all categories to be easy vs. not easy (Table; P<0.001 for all). Daily vs. less frequent social support was associated with greater perceived ease of adherence to coming to (75.5% vs. 65.2%, P=0.001) and completing (75.6% vs. 64.3%, P<0.001) dialysis. Memory impairment vs. none was associated with lower ease of adherence in the same categories (66.2% vs. 74.4%, P=0.03; 64.7% vs. 74.7%, P=0.01). History of substance abuse, marital status, living alone, employment, community-dwelling status, and ambulatory assistance were not associated with ease of adherence.

Conclusion

Our results suggest that patients who have depression/anxiety, infrequent social support, or memory impairment are more likely to perceive adherence to various aspects of dialysis treatment as difficult. Further investigation of perceived and actual adherence by these psychosocial factors, which could inform targeted interventions to improve adherence, is warranted.