#3034 Therapeutic compliance: another challenge for patients on chronic hemodialysis

Abstract Background and Aims Therapeutic compliance corresponds to the degree of concordance between the patient's behavior and the recommendations of his doctor. Non-adherence to treatment predispose to high risk of mortality and increases health costs. The objective of our study was to assess the level of compliance in chronic hemodialysis patients and to identify the predictive factors of poor compliance. Method A cross-sectional study was conducted in the hemodialysis center at Taher Sfar Hospital in Mahdia. Medication adherence was assessed using a “compliance assessment test” quiz comprising six questions to which the patient must answer yes or no. Results Sixty-one patients were enrolled. The mean age was 50 ± 13 years (26 - 79 years) with a sex ratio M/F of 1.27. The patients have diabetes mellitus and hypertension in 35% and 68% of cases. They were dialyzed for a long duration (37 ± 15 months) that reaches a maximum of 280 months. The main initial nephropathies were diabetic nephropathy (35.5%) and chronic interstitial nephropathy (23.5%). Adherence was poor in 16.9 % of patients, average in 55.9% of patients while 27.1% were good adherents. Polymedication and missing of treatment were the leading causes of non-adherence. In univariate analyses, the socio-economic level affected significantly the compliance in elderly group as well as high comorbidity score (Charlson) (p0.04) and diabetes status (p=0.04). No significant difference was found between elderly and young group in term of compliance to treatment. Conclusion Compliance is a dynamic behavior that is difficult to predict and requires constant monitoring. In our hemodialysis center it turned out to be good; we must insist on the therapeutic education of patients and minimize the list to the necessary.