Impact of Pharmacist Counseling Strategy On Adherence And Knowledge of Chronic Kidney Disease Patients: Quasi-Experimental Assessment

https://doi.org/10.22146/ahj.v8i1.110980

Ulfa Filliana(1*), Sholikhah Rosvita Oktasari(2), Sri Rahmat Molidia(3), Nanang Munif Yasin(4), Susi Ari Kristina(5)

(1) Universitas Wahid Hasyim
(2) Faculty of Pharmacy, Universitas Muhammadiyah Surakarta
(3) Department of Pharmacology and Clinical Pharmacy, Faculty of Medicine, Universitas Tanjungpura
(4) Faculty of Pharmacy, Universitas Gadjah Mada
(5) Faculty of Pharmacy, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Background: Chronic kidney disease is a progressive condition that requires proper management to slow the decline in kidney function and reduce the risk of complications. Patients with low adherence have an increased risk of kidney progression, and knowledge level plays an important role in the treatment of kidney patients and in collaborative treatment decision-making. This study aims to evaluate the impact of a pharmacist counselling strategy on adherence and knowledge levels in CKD patients.

Method: The method was quasi-experimental, with a pretest-posttest design, comparing the intervention and control groups. The intervention was carried out once a week for 1 month, using leaflets as a tool, with inclusion and exclusion criteria, among chronic kidney disease patients during September-October 2023.

Result:  The study included 57 patients: 29 in the control group and 28 in the intervention group. The result showed that in the intervention group, there was an increase in knowledge, with a difference between pretest and posttest scores of Δ 8.79±7.802, compared to the control group, which showed a decrease in scores of Δ -0,49±4,932 (p=0.000). Adherence in the intervention group increased by Δ 2,71±1,822 compared to the control group, while adherence in the control group decreased by Δ -0,44±1,152 (p=0.000). A contributing factor to the patient's level of knowledge and compliance was duration of hemodialysis, p=0.032.

Conclusion: The conclusion was that the pharmacist counselling strategy significantly improved CKD patient knowledge and medication adherence, and that the duration of hemodialysis significantly contributed to CKD patients' knowledge.


Keywords


knowledge, adherence, chronic kidney disease, pharmacist strategy, counselling

Full Text:

PDF


References

  1. Yan MT, Chao C Ter, Lin SH. Chronic kidney disease: Strategies to retard progression. Int J Mol Sci [Internet]. 2021 Sep 1 [cited 2025 Aug 29];22(18). Available from: https://pubmed.ncbi.nlm.nih.gov/34576247/
  2. Elendu C, Elendu RC, Enyong JM, Ibhiedu JO, Ishola I V., Egbunu EO, et al. Comprehensive review of current management guidelines of chronic kidney disease. Medicine [Internet]. 2023 Jun 9 [cited 2025 Aug 29];102(23):e33984. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10256423/
  3. Levin A, Ahmed SB, Carrero JJ, Foster B, Francis A, Hall RK, et al. Executive summary of the KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease: known knowns and known unknowns. Kidney Int [Internet]. 2024 Apr 1 [cited 2025 Aug 29];105(4):684–701. Available from: https://pubmed.ncbi.nlm.nih.gov/38519239/
  4. Alkhatib L, Diaz LAV, Varma S, Chowdhary A, Bapat P, Pan H, et al. Lifestyle Modifications and Nutritional and Therapeutic Interventions in Delaying the Progression of Chronic Kidney Disease: A Review. Cureus [Internet]. 2023 Feb 3 [cited 2025 Aug 29];15(2):e34572. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9981552/
  5. Jankowski J, Floege J, Fliser D, Böhm M, Marx N. Cardiovascular Disease in Chronic Kidney Disease Pathophysiological Insights and Therapeutic Options. Circulation [Internet]. 2021 Mar 16 [cited 2025 Aug 29];143(11):1157–72. Available from: https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.120.050686?download=true
  6. Yin P, Wu Q, Shou L, Dong X. Risk factors for anemia in patients with chronic kidney disease: A protocol for systematic review and meta-analysis. Medicine [Internet]. 2021 Oct 8 [cited 2025 Aug 29];100(40):e27371. Available from:https://pmc.ncbi.nlm.nih.gov/articles/PMC8500622/
  7. 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 [Internet]. 2020 May 1 [cited 2025 Aug 29];52(5):903–16. Available from: https://pubmed.ncbi.nlm.nih.gov/32236780/
  8. Cedillo-Couvert EA, Ricardo AC, Chen J, Cohan J, Fischer MJ, Krousel-Wood M, et al. Self-reported Medication Adherence and CKD Progression. Kidney Int Rep [Internet]. 2018 May 1 [cited 2025 Aug 29];3(3):645–51. Available from: https://pubmed.ncbi.nlm.nih.gov/29854972/
  9. Rivera E, Clark-Cutaia MN, Schrauben SJ, Townsend RR, Lash JP, Hannan M, et al. Treatment Adherence in CKD and Support From Health care Providers: A Qualitative Study. Kidney Med [Internet]. 2022 Nov 1 [cited 2025 Aug 29];4(11). Available from: https://pubmed.ncbi.nlm.nih.gov/36339664/
  10. Calleja L, Glass BD, Cairns A, Taylor S. Pharmacist-Led Interventions for Medication Adherence in Patients with Chronic Kidney Disease: A Scoping Review. Pharmacy (Basel) [Internet]. 2023 Nov 30 [cited 2025 Aug 29];11(6):185. Available from: https://pubmed.ncbi.nlm.nih.gov/38133460/
  11. Octaviani DS, Widyawati IY, Suarilah I, Jannah F. Telehealth pada Kepatuhan Diet Pasien Penyakit Ginjal Kronis. Journal of Telenursing (JOTING). 2024 Jun 4;6(1):1607–16.
  12. Toapanta N, Salas-Gama K, Pantoja PE, Soler MJ. The role of low health literacy in shared treatment decision-making in patients with kidney failure. Clin Kidney J [Internet]. 2023 Sep 1 [cited 2025 Aug 29];16(1 S):I4–11. Available from: https://pubmed.ncbi.nlm.nih.gov/37711638/
  13. Al Jeraisy M, Alshammari H, Albassam M, Al Aamer K, Abolfotouh MA. Utility of patient information leaflet and perceived impact of its use on medication adherence. BMC Public Health [Internet]. 2023 Dec 1 [cited 2025 Aug 29];23(1):1–10. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-15346-y
  14. Estrella ML, Allen-Meares P, Ricardo AC, Fischer MJ, Gordon EJ, Carmona-Powell E, et al. Prospective associations of health literacy with clinical outcomes in adults with CKD: findings from the CRIC study. Nephrology Dialysis Transplantation [Internet]. 2022 Apr 1 [cited 2025 Aug 29];38(4):904. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10064835/
  15. Wickramasinghe D, Lynch C, Coombes J, Jayamanne S, Silva S De. Impact of clinical pharmacy services on medication adherence and quality of life in pre-dialysis patients with CKDu: a randomized controlled trial from Sri Lanka. BMC Nephrol [Internet]. 2025 Dec 1 [cited 2025 Aug 29];26(1):1–10. Available from: https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-025-04301-1
  16. Paneerselvam GS, Kah Yee C, Farrukh MJ, Yuda A, Hermansyah A, Mohd. Asmani MF, et al. Impact of pharmacist-led medication review among hemodialysis patients: a systematic review. Journal of Pharmaceutical Policy and Practice [Internet]. 2025 [cited 2025 Aug 29];18(1). Available from: https://pubmed.ncbi.nlm.nih.gov/39911588/
  17. Tuot DS, Plantinga LC, Hsu C yuan, Jordan R, Burrows NR, Hedgeman E, et al. Chronic kidney disease awareness among individuals with clinical markers of kidney dysfunction. Clinical Journal of the American Society of Nephrology. 2011;6(8).
  18. Tuot DS, Zhu Y, Velasquez A, Espinoza J, Mendez CD, Banerjee T, et al. Variation in Patients’ Awareness of CKD according to How They Are Asked. Clinical Journal of the American Society of Nephrology. 2016;11(9).
  19. Havas K, Douglas C, Bonner A. Person-centred care in chronic kidney disease: a cross-sectional study of patients’ desires for self-management support. BMC Nephrol. 2017 Jan 13;18(1):1–9.
  20. Soeli YM, Amu IV, Sune ZA. Stress Level And Hemodialysis Duration Of Patients With Chronic Kidney Failure Undergoing Hemodialysis. Jurnal Aisyah : Jurnal Ilmu Kesehatan. 2021 Sep 14;6.
  21. Campbell ZC, Dawson JK, Kirkendall SM, McCaffery KJ, Jansen J, Campbell KL, Lee VW, Webster AC. Interventions for improving health literacy in people with chronic kidney disease. Cochrane Database Syst Rev. 2022.
  22. Akmalia LN, Probosuseno, Ikawati Z. Pengaruh Edukasi melalui Whatsapp terhadap Pengetahuan, Kepatuhan dan Kualitas Hidup Pasien Hemodialisis Rutin di Rsup Dr. Sardjito Yogyakarta. [Yogyakarta]: Universitas Gadjah Mada; 2018.
  23. Spencer JC, Wheeler SB. A systematic review of Motivational Interviewing interventions in cancer patients and survivors. Patient Educ Couns. 2016;
  24. Werbrouck A, Swinnen E, Kerckhofs E, Buyl R, Beckwée D, De Wit L. How to empower patients? A systematic review and meta-analysis. Transl Behav Med. 2018;8:660–74.
  25. Latif AA lliya A, Lee KW, Phang K, Rashid AA, Chan NN, Peh SC, et al. Patient-related factors associated with medication adherence behavior in patients with end-stage renal disease: A systematic review. Vol. 34, Tzu Chi Medical Journal. Wolters Kluwer Medknow Publications; 2022. p. 473–84.
  26. Adiningrum N, Andayani TM, Kristina SA. Pengaruh Edukasi Apoteker dalam Program Si Pena Hati terhadap Kepatuhan, Hasil Terapi dan Kualitas Hidup Pasien Hemodialisis di Rsud Dr. Loekmono Hadi Kudus. [Yogyakarta]: Universitas Gadjah Mada; 2020.
  27. Syafitri IW, Yasin NM, Sari IP. Pengaruh Edukasi oleh Apoteker dengan Metode Brief Counseling terhadap Pengetahuan, Kepatuhan dan Glukosa Darah Pasien Dm Tipe 2. [Yogyakarta]: Universitas Gadjah Mada; 2022.
  28. Wiyatami MA, Yasin NM, Sari IP. Hubungan Tingkat Pengetahuan dan Kepatuhan Setelah Pemberian Brief Counseling Terhadap Luaran Klinik Pasien Hipertensi. JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice). 2023 Mar 31;13(1):33.
  29. Gahrouei RB, Ranganathan S. A STUDY ON ASSESSMENT OF MEDICATION ADHERENCE IN HEMODIALYSIS PATIENTS [Internet]. 2025. Available from: http://medrxiv.org/lookup/doi/10.1101/2025.02.10.25321945
  30. Kuntz J, Safford M, Singh J, Phansalkar S, Slight S, Her Q, et al. Patient-centered interventions to improve medication management and adherence: a qualitative review of research findings. Patient Educ Couns. 2014;3(87):310–26.
  31. Kretchy IA, Owusu-Daaku FT, Danquah SA, Asampong E. A psychosocial perspective of medication side effects, experiences, coping approaches and implications for adherence in hypertension management. Clin Hypertens. 2015 Dec;21(1).
  32. Boeni F, Spinatsch E, Suter K, Hersberger KE, Arnet I. Effect of drug reminder packaging on medication adherence: A systematic review revealing research gaps. Syst Rev. 2014 Mar 24;3(1).
  33. Mosleh S, Darawad M. Patients’ adherence to healthy behavior in coronary heart disease. J Cardiovasc Nurs. 2015;6(30):310–26.
  34. Ge L, Heng BH, Yap CW. Understanding reasons and determinants of medication non-adherence in community-dwelling adults: a cross-sectional study comparing young and older age groups. BMC Health Serv Res. 2023 Dec 1;23(1).
  35. Dewayani IGAT, Lisnawati K, Purwanti IS. The Relationship of Duration of Hemodialysis with Coping Mechanisms of Chronic Kidney Disease Patients Underwent Hemodialysis. Basic and Applied Nursing Research Journal. 2022 Jun 30;3(1):24–9.
  36. Cardol CK, Boslooper-Meulenbelt K, van Middendorp H, Meuleman Y, Evers AWM, van Dijk S. Psychosocial barriers and facilitators for adherence to a healthy lifestyle among patients with chronic kidney disease: a focus group study. BMC Nephrol [Internet]. 2022 Dec 1 [cited 2025 Aug 29];23(1):1–16. Available from: https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-022-02837-0
  37. Mirzaei-Alavijeh M, Hamzeh B, Omrani H, Esmailli S, Khakzad S, Jalilian F. Determinants of medication adherence in hemodialysis patients: a cross-sectional study based on capability-opportunity-motivation and behavior model. BMC Nephrol [Internet]. 2023 Dec 1 [cited 2025 Aug 29];24(1). Available from: https://pubmed.ncbi.nlm.nih.gov/37316774/
  38. Mohammadnezhad G, Ehdaivand S, Sebty M, Azadmehr B, Ziaie S, Esmaily H. Chronic kidney disease and adherence improvement program by clinical pharmacist-provided medication therapy management; a quasi-experimental assessment of patients’ self-care perception and practice. BMC Nephrol [Internet]. 2024 Dec 1 [cited 2025 Aug 29];25(1). Available from: https://pubmed.ncbi.nlm.nih.gov/39696084/



DOI: https://doi.org/10.22146/ahj.v8i1.110980

Article Metrics

Abstract views : 479 | views : 353

Refbacks

  • There are currently no refbacks.


Bookmark and Share


Copyright (c) 2026 Academic Hospital Journal

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Currently, Academic Hospital Journal indexed by:

google-scholar garuda

dimensions logo

 


 

Web Analytics

View My Stats

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License