Leicester study warns of dangers of non-adherence after finding that 45% of kidney patients had not taken their medication as prescribed.
When patients suffering from chronic health conditions don’t take their medicine as prescribed it can lead to unnecessary interventions and poor outcomes.
A study carried out by researchers at the National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands (ARC EM) and the NIHR Leicester Biomedical Research Centre (BRC) discovered that around 45% of chronic kidney disease patients attending a routine clinic in Leicester hadn’t taken their medicine as prescribed, using an objective test.
Chronic kidney disease (CKD) is one of the leading causes of death worldwide, it is a long-term condition where the kidneys do not work as well as they should.
Around 13% of the world’s population are living with CKD and over the last 20 years there has been over a 40% increase in mortality rates.
PhD researcher Hanad Osman
PhD researcher, Hanad Osman, who works within the Leicester Diabetes Centre, said: “Helping patients improve their levels of adherence to medication is absolutely key to their future health. However, until recently, it has been difficult to measure non-adherence due to the lack of objective tools in busy clinics, and self-reporting has been found to be unreliable.”
This study used chemical adherence testing (CAT) to determine the presence or absence of 70 of the most common cardio-metabolic medications in urine samples collected from 106 consecutive patients attending the renal clinic at the University Hospitals of Leicester NHS Trust.
The study, published in October 2023 in Kidney International Reports, found that 45% of the group was non-adherent to at least one of the prescribed cardio-metabolic medications, and 14.2% were found to be non-adherent to all of their prescribed cardio-metabolic medications.
Professor Kamlesh Khunti, Director of the NIHR Applied Research Collaboration (ARC) East Midlands, Professor of Diabetes at the University of Leicester and Co-Director of the Leicester Diabetes Centre said: “Multimorbidity is a pressing challenge in today's healthcare landscape. The findings from this study underscore the critical need to address medication adherence in patients with multiple chronic conditions to ensure optimal health outcomes.”
Dr Pankaj Gupta, Consultant and the co-director of the National Centre for Adherence Testing (NCAT) said: “We hope that the results of this study show that this easy-to-use CAT method performed in our National Centre for Adherence Testing (NCAT) can help to identify patients that are finding it difficult to take medications due to having multiple medications or side effects or a lack of understanding of their condition.
“We also hope it highlights to patients the importance of having open honest conversations with their doctor about any problems they’re having with their medication, as not taking it properly can worsen their condition.”
Nigel Brunskill, Professor of Renal Medicine and Consultant Nephrologist at University Hospitals of Leicester NHS Trust, said: “Managing kidney disease often requires patients to take multiple different medications. Our study shows that this can be difficult for patents and emphasizes the need for health carers to support patients with their treatment to achieve best outcomes.