How Your Team Can Help Resolve Dialysis Non-Adherence

As a healthcare professional, you know your treatment plans are only as powerful as your patients’ commitment. Your patients’ quality of life not only depends on your expertise but also on how well they implement their care plan after they leave your office. And when it comes to patients with end-stage renal disease (ESRD), non-adherence to dialysis and supporting factors such as diet and medication can lead to severe complications and an increased risk of mortality. Unfortunately, at least 50 % of hemodialysis patients are believed to be non-adherent, according to a study by the Department of Internal Medicine at Cairo University.

So what can you and your team do to ensure dialysis patients adhere to their medical treatment plan and drive better outcomes? Here are a few things you can do to resolve patient non-adherence.

Thoroughly explain why they need the treatment.
As a healthcare professional who spends each workday immersed in nephrology, it can be easy to assume your patients understand their condition and its risks [at least partially] as well as you do. But this isn’t always the case.“As many as one in five patients don't fill the original prescription because the doctor didn't convince them that they really needed it,” says Rick Kellerman, chair of the Department of Family and Community Medicine at Kansas University School of Medicine, in an article for Medscape.

It’s critical you provide detailed explanations for why each part of the treatment plan is essential to the patients’ quality of life, and don’t leave out the risks of skipping dialysis or missing doses of medication.

Make it as simple as possible.
Stay away from heavy jargon and focus on making your explanations as simple and straightforward as possible. Ask for a verbal confirmation that they understand their treatment plan, especially the importance of their dialysis appointments.  

Also, be sure to provide resources such as step-by-step plans and care checklists your patients can refer back to in case they don’t retain everything you share during their visit. For example, information such as diet plans can be helpful for patients to have on hand when they go to the grocery store or to a restaurant for a meal.

Follow up regularly.
Make sure you or someone on your team is following up with patients at regular intervals. If possible, consider using telehealth technology to consult with patients between visits and ensure they’re adhering to their plan. This is especially critical in cases where patients are on home dialysis, live alone or live in rural areas.

If a patient misses an appointment, be sure to assist them in re-scheduling as soon as possible. While scheduling conflicts may arise from time to time, patients who habitually skip checkups may also be at risk for dialysis non-adherence.

Keep the lines of communication open.If a patient was recently diagnosed, they might feel overwhelmed by all the new information—as well as the time requirements associated with dialysis. That’s why it’s crucial you make sure they know they can contact you or one of your team members any time they have a question or concern about their care plan. By establishing open doctor-patient communication, you can reduce the risk of patients following misinformation they’ve discovered through another source.

Dialysis non-adherence puts a patient in jeopardy of developing additional health concerns and developing severe complications. By following these four tips, you can help resolve non-adherence issues and make sure your patients comply with the plan you create.