The Effects of Peer Education on Treatment Adherence among Patients Receiving Hemodialysis: A Randomized Controlled Trial
Abstract
Background: Non‑adherence to treatments increases the rates of hemodialysis complications, hospitalization, and mortality. One strategy for adherence improvement is peer education. This study aimed to investigate the effects of peer education on treatment adherence among patients receiving hemodialysis. Materials and Methods: This was a randomized controlled trial. Patients in the control group were provided just with routine care, and the intervention group received peer education. Treatment adherence was assessed both before and after the intervention via the End‑Stage Renal Disease (ESRD) Adherence Questionnaire. Data analysis was conducted by the Chi‑square, the Mann‑Whitney U, the paired‑sample t, and the independent‑sample t tests. Results: There were no significant between‑group differences in terms of the pre‑test mean scores of Adherence to regular attendance at hemodialysis sessions (t = 0.19, p = 0.85), Adherence to the prescribed medications (t = 0.46, p = 0.64), and Adherence to fluid restrictions (t = 0.24, p = 0.81). The same finding was observed after the intervention, except for the mean score of the adherence to fluid restrictions dimension which was significantly greater in the intervention group (t = 2.86, p = 0.006). Moreover, no significant changes were observed in the mean scores of treatment adherence dimensions in the control group. However, in the intervention group, the mean scores of the adherence to regular attendance at hemodialysis sessions (t = 3.79, p < 0.001) and the adherence to fluid restrictions dimensions were significantly greater than their pre‑test values (t = 4.47, p < 0.001). Conclusions: Education by peer groups improves the compliance of patients with regard to the consumption of fluids in the interval between two dialysis sessions.
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Taylor KS, Umeukeje EM, Santos SR, McNabb KC, Crews DC, Hladek MD. Context matters: A qualitative synthesis of adherence literature for people on hemodialysis. Kidney360 2022;4:41 53.
Vijay V, Kang HK. The worldwide prevalence of nonadherence to diet and fluid restrictions among hemodialysis patients: A systematic review and meta analysis. J Ren Nutr 2022;32:658 69.
Tayebi A, Einollahi B, Rahimi A, Sirati Nir M. Non adherence to treatment among iranian dialysis patients, a systematic review. Iran J Kidney Dis 2019;13:347 61.
Murali KM, Mullan J, Roodenrys S, Hassan HC, Lambert K, Lonergan M. Strategies to improve dietary, fluid, dialysis or medication adherence in patients with end stage kidney disease on dialysis: A systematic review and meta analysis of randomized intervention trials. PLoS One 2019;14:e0211479.
Dantas LG, de Seixas Rocha M, Junior JAM, Paschoalin EL, Paschoalin SR, Sampaio Cruz CM. Non adherence to haemodialysis, interdialytic weight gain and cardiovascular mortality: A cohort study. BMC Nephrol 2019;20:1 10.
Chen X, Hua L, Zhang C, Xu Z, Cao X, Cai Y. Effect of peer support on improving self management ability in peritoneal dialysis patients A randomized controlled trial. Ann Palliat Med 2021;10:3028 38.
Chironda G, Bhengu B, Manwere A. Models and theories of care applicable to predicting and improving adherence behaviours among Chronic Kidney Disease (CKD) patients. Rwanda J Med Health Sci 2019;2:48 58.
Heydarzadeh N, Rezaee M, Habibzadeh H. Effect of peer education on self efficacy of dialysis patients referring to educational medical centers in Urmia in 2019. J Clin Nurs Midwifery 2020;9:719 27.
Golestaneh L, Melamed M, Kim RS, St Clair Russell J, Heisler M, Villalba L, et al. Peer mentorship to improve outcomes in patients on hemodialysis (PEER HD): A randomized controlled trial protocol. BMC Nephrol 2022;23:1 10.
Boucher LM, Liddy C, Mihan A, Kendall C. Peer led self management interventions and adherence to antiretroviral therapy among people living with HIV: A systematic review. AIDS Behav 2020;24:998 1022.
Denison JA, Burke VM, Miti S, Nonyane BA, Frimpong C, Merrill KG, et al. Project YES! Youth Engaging for Success: A randomized controlled trial assessing the impact of a clinic based peer mentoring program on viral suppression, adherence and internalized stigma among HIV positive youth (15 24 years) in Ndola, Zambia. PLoS One 2020;15:e0230703.
Lobis YB, Murti B, Prasetya H. Influences of Peer Support Group and psychosocioeconomic determinants on treatment compliance in HIV/AIDS patients: A path analysis evidence from Sragen, Central Java. J Epidemiol Public Health 2020;5:348 58.
Ho J, Corden ME, Caccamo L, Tomasino KN, Duffecy J, Begale M, et al. Design and evaluation of a peer network to support adherence to a web based intervention for adolescents. Internet Interv 2016;6:50 6.
Evans M, Barker H, Peddireddy S, Zhang A, Luu S, Qian Y, et al. Peer-delivered services and peer support reaching people with schizophrenia: A scoping review. International Journal of Mental Health. 2021;22:1-23.
Proudfoot J, Parker G, Manicavasagar V, Hadzi Pavlovic D, Whitton A, Nicholas J, et al. Effects of adjunctive peer support on perceptions of illness control and understanding in an online psychoeducation program for bipolar disorder: A randomised controlled trial. J Affect Disord 2012;142:98 105.
Fortuna KL, Myers AL, Ferron J, Kadakia A, Bianco C, Bruce ML, et al. Assessing a digital peer support self management intervention for adults with serious mental illness: Feasibility, acceptability, and preliminary effectiveness. J Ment Health 2022;31:833 41.
Thompson DM, Booth L, Moore D, Mathers J. Peer support for people with chronic conditions: A systematic review of reviews. BMC Health Serv Res 2022;22:427.
Rhee H, Love T, Harrington D, Walters L, Mammen J, Sloand E. Long term effects of a peer led asthma self management program on asthma outcomes in adolescent peer leaders. Patient Educ Couns 2021;104:1415 22.
Russell JJSC. Development and Evaluation of a Peer-to-Peer Intervention to Increase Self-Management among Adult In-Center Hemodialysis Patients .PhD Theses and Dissertations . Richmond: Virginia Commonwealth University; 2016.
Astuti NP, Baidhowy AS, Nugroho EG. The relationship between fear of covid-19 and adherence for people with end stage renal diseases with hemodialysis. Jurnal Ilmu Keperawatan Medikal Bedah. 2022;17;5:43-50.
Kim Y, Evangelista LS, Phillips LR, Pavlish C, Kopple JD. The End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ): testing the psychometric properties in patients receiving in-center hemodialysis. Nephrology nursing journal: journal of the American Nephrology Nurses' Association. 2010;37:377.
Borji M, Otaghi M, Miri M, Azami M, Tavan H. Adherence to treatment in older adults on hemodialysis in Ilam in 2014-15. Nursing Journal of the Vulnerable. 2016;3:15-26.
Yangöz ŞT, Özer Z, Boz İ. Comparison of the effect of educational and self-management interventions on adherence to treatment in hemodialysis patients: A systematic review and meta-analysis of randomized controlled trials. Int J Clin Pract 2021;75:e13842.
Wu SFV, Wang TJ, Liang SY, Lin LJ, Lu YY, Lee MC. Differences in self-care knowledge, self-efficacy, psychological distress and self-management between patients with early-and end-stage chronic kidney disease. J Clin Nurs 2022;31:2287 95.
Mirmazhari R, Ghafourifard M, Sheikhalipour Z. Relationship between patient activation and self efficacy among patients undergoing hemodialysis: A cross sectional study. Ren Replace Ther 2022;8:1 11.
Seng JJB, Tan JY, Yeam CT, Htay H, Foo WYM. Factors affecting medication adherence among pre dialysis chronic kidney disease patients: A systematic review and meta analysis of literature. Int Urol Nephrol 2020;52:903 16.
Gunes D. Evaluation of self care agency and perceived social support in patients undergoing hemodialysis. Int J Caring Sci 2020;13:250 7.
Doosti Irani M, Abazari P, Babaei S, Shahgholian N. Facilitators of adherence to Self management in type 2 diabetic patients: A phenomenological study. Iran J Endocrinol Metab 2009;11:257 64.
Abebe A, Arba A, Paulos K, Abera W, Sidamo T, Shiferaw S, et al. The lived experience of primary family caregivers of patients on hemodialysis treatment in Southern Ethiopia: A phenomenological study. Int J Nephrol Renovasc Dis 2022;15:41 52.
Sukartini T, Efendi F, Putri NS. A phenomenological study to explore patient experience of fluid and dietary restrictions imposed by hemodialysis. Journal of Vascular Nursing. 2022;40:105-11.
Kosse RC, Bouvy ML, Belitser SV, De Vries TW, Van Der Wal PS, Koster ES. Effective engagement of adolescent asthma patients with mobile health–supporting medication adherence. JMIR mHealth uHealth 2019;7:e12411.
Opiyo RO, Nyasulu PS, Olenja J, Zunza M, Nguyen KA, Bukania Z, et al. Factors associated with adherence to dietary prescription among adult patients with chronic kidney disease on hemodialysis in national referral hospitals in Kenya: A mixed methods survey. Ren Replace Ther 2019;5:1 14.
Hassan RM, Mohamed HS, Rahman A, Khalifa AM. Relation between therapeutic compliance and functional status of patients undergoing hemodialysis. Am J Nurs 2020;8:632 40.
Gebrie MH, Ford J. Depressive symptoms and dietary non adherence among end stage renal disease patients undergoing hemodialysis therapy: Systematic review. BMC Nephrol 2019;20:1 7.
Griva K, Ng H, Loei J, Mooppil N, McBain H, Newman S. Managing treatment for end stage renal disease–A qualitative study exploring cultural perspectives on facilitators and barriers to treatment adherence. Psychol Health 2013;28:13 29.
Parker K, Bull-Engelstad I, Aasebø W, Von der Lippe N, Reier-Nilsen M, Os I, et al. Medication regimen complexity and medication adherence in elderly patients with chronic kidney disease. Hemodial Int 2019;23:333 42.
Berg RC, Page S, Øgård Repål A. The effectiveness of peer support for people living with HIV: A systematic review and meta analysis. PLoS One 2021;16:e0252623.
Borji M, Otaghi M, Miri M, Azami M, Tavan H. Adherence to treatment in older adults on hemodialysis in Ilam in 2014-15. Nursing Journal of the Vulnerable. 2016;3:15-26.
Aminde LN, Tindong M, Ngwasiri CA, Aminde JA, Njim T, Fondong AA, et al. Adherence to antidiabetic medication and factors associated with non adherence among patients with type 2 diabetes mellitus in two regional hospitals in Cameroon. BMC Endocr Disord 2019;19:1 9.
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