Assessment of management and quality of life among patients with chronic kidney disease at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
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Date
2018-01
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Addis Ababa Universty
Abstract
Assessment of management and quality of life among patients with chronic kidney disease at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
Belayneh Kefale
Addis Ababa University, 2018
Management of co-morbidities and quality of life (QoL) among patients with chronic kidney disease (CKD) is an important issue for the delivery of optimum health care. Hence, the present study aimed to assess the management and QoL in patients with CKD at Tikur Anbessa Specialized Hospital (TASH). A cross sectional study was conducted at TASH from May to September 2017. About 256 patients were recruited through systematic random sampling technique and data were collected using data abstraction format designed for extraction of appropriate patient information as well as validated questionnaire, including, the 8-items Morisky Medication Adherence Scale and the Medical Outcomes Study Short Form 36-Items. About 55% patients with hypertension only were treated with non angiotensin converting enzyme inhibitor (ACEI) based regimens; 57.3% of diabetes mellitus with hypertension treated with combination of insulin and ACEI based regimens; and 44.4% diabetes mellitus only treated with insulin. About three-fourth of patients with anemia and osteodystrophy related complications were treated with iron and calcium based formulations. Adherence rate to CKD medications was found to be 61.3%. Very low income, increased number of prescribed medications and being a farmer were significantly associated with CKD medication non-adherence. Most of the patients missed their medications because of forgetfulness (79.8%). On the other hand, QoL decreased progressively across the stages of CKD. A reduction in physical functioning (p=0.03), bodily pain (p=0.004), vitality (p=0.019) and social functioning (p=0.002) was observed with stages of CKD. High income (β 2.6; 95%CI: 1.67-3.55), p<0.001) & educational status (β 1.12; 95%CI: 0.62-2.78, p=0.024), and hemoglobin >11g/dl (β 8.36; 95%CI: 6.31-10.41, p<0.001) were predictors of better QoL in the physical component summary, whereas absence of CKD complications (β 2.75; 95%CI: 0.56-4.94, p=0.014), high income (β 1.64; 95%CI: 0.48-2.81, p=0.006) and hemoglobin >11g/dl (β 4.54, 95%CI: 2.01-7.08, p=0.001) were predictors of mental component summary. Thus, the finding of this study indicated that management practice and medication adherence was suboptimal. In addition, QoL decreased in all stages of CKD, which warrants the need for health care professionals engaged in renal care address these issue aggressively.
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Keywords
Chronic kidney disease, management practice, medication adherence, quality of life, SF-36