Exploration of the Relationship Between Quality of Life and Medication Beliefs with Non-Adherence in Hemodialysis Patients
Article metrics
OJS usage and citation sourcesViews and downloads are recorded by OJS; statistics processing may be delayed. A dash means the source count is unavailable. Search Google Scholar
Article Sidebar
Sulistia Suryaman, Zakky Cholisoh (2025). Exploration of the Relationship Between Quality of Life and Medication Beliefs with Non-Adherence in Hemodialysis Patients. Journal of Pharmaceutical and Sciences, JPS Volume 8 Nomor 3 (2025). https://doi.org/10.36490/journal-jps.com.v8i3.1029
Main Article Content
Abstract
Background: Poor medication adherence is common among hemodialysis patients and is associated with adverse clinical outcomes. However, factors such as health-related quality of life (QoL) and medication beliefs remain underexplored as determinants of non-adherence in this population. Objective: This systematic review aims to synthesise the evidence regarding the relationship between QoL, medication beliefs, and pharmacological non-adherence in patients undergoing hemodialysis (HD). Methods: A comprehensive literature search was conducted using electronic databases (PubMed, Scopus, and Google Scholar) for observational studies published between January 2015 and July 2, 2025. Studies were included if they involved adult hemodialysis patients and examined QoL and/or medication beliefs concerning pharmacological non-adherence. Results: Six observational studies, encompassing 1,698 hemodialysis patients from various countries, met the inclusion criteria. The synthesised evidence indicated that poorer QoL (particularly depression and poor sleep quality), higher burden of physical symptoms, and specific medication beliefs (e.g., concerns about side effects and low perceived necessity of medications) were significantly associated with increased non-adherence. Conclusion: Non-adherence among hemodialysis patients is influenced by the complex interaction of psychosocial factors, including QoL and individual medication beliefs. To improve adherence, interventions should be developed to target these factors through health education, psychological support, and patient-centred care. Further integrative and contextual research is needed to strengthen understanding and develop more effective interventions.
Article Details
Section
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
How to Cite
References
Bello AK, Okpechi IG, Osman MA, Cho Y, Htay H, Jha V, et al. Epidemiology of haemodialysis outcomes. Nat Rev Nephrol 2022;18:378 95. https://doi.org/10.1038/s41581-022-00542-7.
Francis A, Harhay MN, Ong ACM, Tummalapalli SL, Ortiz A, Fogo AB, et al. Chronic kidney disease and the global public health agenda: an international consensus. Nat Rev Nephrol 2024;20:473–85. https://doi.org/10.1038/s41581-024-00820-6.
Miftakhul A, Bosniawan A, Ayatulloh D, Fahmi N, Laily R. Relationship Between Anxiety, Depression, And Quality Of Life Among Hemodialysis Patients: A Systematic Review Abstrak Times new roman :11 Spasi 1. vol. 1. 2024.
Rikos N, Kassotaki A, Frantzeskaki C, Fragiadaki M, Mpalaskas A, Vasilopoulos G, et al. Investigation of Perception of Quality of Life and Psychological Burden of Patients Undergoing Hemodialysis—Quality of Life of Hemodialysis Patients. Nurs Rep 2023;13:1331–41. https://doi.org/10.3390/nursrep13030112.
Rustandi H, Sofais DAR, Hasanuddin Y. Analysis of Risk Factors Related to Quality of Life in Kidney Failure Patients Undergoing Hemodialysis: A Single-Centre Observational Study at Besemah Regional Hospital, Pagaralam, Indonesia. Archives of The Medicine and Case Reports 2024;5:907–19. https://doi.org/10.37275/amcr.v5i4.611.
Sritheran G, Id P, Kwing L, Kenneth C, Aftab RA, Sirisinghe RG, et al. PLOS ONE Enhancing medication management in hemodialysis patients : Exploring the impact of patient-centred pharmacist care and motivational interviewing 2024:1–13. https://doi.org/10.1371/journal.pone.0300499.
Wahyuni NWS, Kamaryati NP, Rismawan M, Suantika PIR. The Determining Factors of Quality of Life in Chronic Kidney Disease Patients with Hemodialysis in Hospitals: A Literature Review. Babali Nursing Research 2025;6:212–25. https://doi.org/10.37363/bnr.2025.61454.
Barello S, Anderson G, Acampora M, Bosio C, Guida E, Irace V, et al. The effect of psychosocial interventions on depression, anxiety, and quality of life in hemodialysis patients: a systematic review and a meta-analysis. Int Urol Nephrol 2023;55:897–912. https://doi.org/10.1007/s11255-022-03374-3.
Tao WW, Tao XM, Wang Y, Bi SH. Psycho-social and educational interventions for enhancing adherence to dialysis in adults with end-stage renal disease: A meta-analysis. J Clin Nurs 2020;29:2834–48. https://doi.org/10.1111/jocn.15301.
Horne R, Chapman SCE, Parham R, Freemantle N, Forbes A, Cooper V. Understanding patients’ adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework. PLoS One 2013;8:e80633.
Ghimire S, Castelino RL, Lioufas NM, Peterson GM, Zaidi STR. Nonadherence to medication therapy in haemodialysis patients: a systematic review. PLoS One 2015;10:e0144119.
Ossareh S, Tabrizian S, Zebarjadi M, Joodat RS. Prevalence of Depression in Maintenance Hemodialysis Patients and Its Correlation With Adherence to Medications. Vol. 8. 2014.
Huertas-vieco MP, Pérez-garcía R, Albalate M, Sequera P De, Ortega M, Puerta M, et al. Psychosocial factors and adherence to drug treatment in patients on chronic haemodialysis 2014:737–42. https://doi.org/10.3265/Nefrologia.pre2014.Jul.12477.
Hamza MA, Ullah S, Ahsan H, Ali W, Masud M, Ahmed A. Health literacy, illness perception, and their association with medication adherence in end-stage renal disease. Int Urol Nephrol 2025:1–16.
Kaneez M, Zaidi SMJ, Zubair A Bin, Rehan M, Hassan A, Sarwar Z, et al. Sleep quality and compliance to medical therapy among hemodialysis patients with moderate-to-severe depression: a cross-sectional study. Cureus 2021;13.
Nagasawa H, Tachi T, Sugita I, Esaki H, Yoshida A, Kanematsu Y, et al. The effect of quality of life on medication compliance among dialysis patients. Front Pharmacol 2018;9. https://doi.org/10.3389/fphar.2018.00488.
FD B, Darvizeh Z, SS. B. The relationship between hemodialysis patients’ treatment adherence, procrastination, and difficulty in emotion regulation: A cross-sectional study in southeast Iran. Front Psychol 2023. https://doi.org/10.3389/fpsyg.2022.1041912 PM - 36726495 PMC - PMC9885004.
Lee SF, Chong CP. Association of Necessity-Concerns Framework with medication adherence among Malaysian hemodialysis patients: A multicenter cross-sectional study. J Appl Pharm Sci 2022;12:61–8.
Mechta Nielsen T, Marott T, Hornum M, Feldt-Rasmussen B, Kallemose T, Thomsen T. Non-adherence, medication beliefs and symptom burden among hemodialysis patients: a cross-sectional study. BMC Nephrol 2023;24. https://doi.org/10.1186/s12882-023-03371-3.
FD B, Darvizeh Z, SS. B. The relationship between hemodialysis patients’ treatment adherence, procrastination, and difficulty in emotion regulation: A cross-sectional study in southeast Iran. Front Psychol 2023. https://doi.org/10.3389/fpsyg.2022.1041912 PM - 36726495 PMC - PMC9885004.
Lee SF, Chong CP. Association of Necessity-Concerns Framework with medication adherence among Malaysian hemodialysis patients: A multicenter cross-sectional study. J Appl Pharm Sci 2022;12:61–8.
Belhmer FS, Al Amad MA, Albitahi MH, Babattah FK. Adherence to Treatment Regimens Among End-Stage Renal Disease Patients : A Cross-Sectional Study 2025:143 50.
Chan AHY, Horne R, Hankins M, Chisari C. The Medication Adherence Report Scale: A measurement tool for eliciting patients’ reports of nonadherence. Br J Clin Pharmacol 2020;86:1281–8. https://doi.org/10.1111/bcp.14193.
Lu Y, Zhai S, Liu Q, Dai C, Liu S, Shang Y, et al. Correlates of symptom burden in renal dialysis patients: a systematic review and meta-analysis. Ren Fail 2024;46:2382314.
Foot H, La Caze A, Gujral G, Cottrell N. The necessity–concerns framework predicts adherence to medication in multiple illness conditions: A meta-analysis. Patient Educ Couns 2016;99:706–17.
Alzahrani AMA. Prevalence of Non-adherence to Prescribed Medications among Hemodialysis Patients in Makkah City. Saudi Journal of Kidney Diseases and Transplantation 2022;33:526–34. https://doi.org/10.4103/1319-2442.388187.
Aggarwal HK, Jain D, Meel S. Impact of patient education and knowledge on medication adherence in chronic kidney disease patients. Journal, Indian Academy of Clinical Medicine 2018;19:166 74.
DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment meta-analysis of the effects of anxiety and depression on patient adherence. Archives of Internal Medicine 2000;160:2101–7. https://doi.org/10.1001/archinte.160.14.2101.
Spernak SM, Moore PJ, Hamm LF. Depression, constructive thinking and patient satisfaction in cardiac treatment adherence. Psychology, Health and Medicine 2007;12:172–89. https://doi.org/10.1080/10556790500465631.
Hooper LM, Tomek S, Roter D, Carson KA, Mugoya G, Cooper LA. Depression, patient characteristics, and attachment style: Correlates and mediators of medication treatment adherence in a racially diverse primary care sample. Primary Health Care Research and Development 2016;17:184–97. https://doi.org/10.1017/S1463423615000365.
Amato L, Giannetta N, Taborri S, Dionisi S, Panattoni N, Di Simone E, et al. Sleep Quality and Medication Adherence in Older Adults: A Systematic Review. Clocks and Sleep 2024;6:488–98. https://doi.org/10.3390/clockssleep6030032.
Riegel B, Moelter ST, Ratcliffe SJ, Pressler SJ, De Geest S, Potashnik S, et al. Excessive daytime sleepiness is associated with poor medication adherence in adults with heart failure. Journal of Cardiac Failure 2011;17:340–8. https://doi.org/10.1016/j.cardfail.2010.11.002.
Rosenthal TC, Majeroni BA, Pretorius R, Malik K. Fatigue: An overview. American Family Physician 2008;78:1173–9.
Sarzi-Puttini P, Batticciotto A, Talotta R, Atzeni F. Differential diagnosis of vasovagal syncope: Myalgic encephalomyelitis/chronic fatigue syndrome. Vasovagal Syncope, 2015, p. 197–211. https://doi.org/10.1007/978-3-319-09102-0_16.
Horne CE, Abel WM, Crane PB. Fatigue, Stress, and Blood Pressure Medication Adherence by Race After Myocardial Infarction. Journal for Nurse Practitioners 2023;19. https://doi.org/10.1016/j.nurpra.2023.104757.
Soltani S, Hollstein MM, Berliner D, Buhl T, Bauersachs J, Werfel T, et al. Symptom severity reflected by NYHA grade is independently associated with pruritus in chronic heart failure patients. Journal of the European Academy of Dermatology and Venereology 2024;38:1410–8. https://doi.org/10.1111/jdv.19931.
Schneider G. Diagnosis of psychological aspects in chronic pruritus. Hautarzt 2020;71:506–10. https://doi.org/10.1007/s00105-020-04596-1.
Shiyanbola OO, Pigarelli DLW, Unni E, Smith PD, Maurer MA, Huang Y. Design and Rationale of a Mixed Methods Randomized Control Trial: ADdressing Health Literacy, bEliefs, adheRence and Self-Efficacy (ADHERE) Program to Improve Diabetes Outcomes. Contemporary Clinical Trials Communications 2019;14:100326. https://doi.org/10.1016/j.conctc.2019.100326.
Rasmussen SEVP, Ferzola A, Cooney CM, Shores JT, Lee WPA, Goldman EO, et al. Psychosocial Factors and Medication Adherence Among Recipients of Vascularized Composite Allografts. Sage Open Medicine 2020;8. https://doi.org/10.1177/2050312120940423.
Huang Y, Shiyanbola OO, Smith PD. Association of Health Literacy and Medication Self-Efficacy With Medication Adherence and Diabetes Control. Patient Preference and Adherence 2018;Volume 12:793–802. https://doi.org/10.2147/ppa.s153312.
Shiyanbola OO, Unni E, Huang Y, Lanier C. Using the Extended Self-Regulatory Model to Characterise Diabetes Medication Adherence: A Cross-Sectional Study. BMJ Open 2018;8:e022803. https://doi.org/10.1136/bmjopen-2018-022803.
Oever FJ Van Den, Vasbinder EC, Schrama YC, Koster ES, Visscher BB, Bemt PMLA Van Den, et al. Patient Education and Counselling Medication-related health literacy in patients on hemodialysis assessed with the RALPH interview guide. Patient Educ Couns 2025;138:109203. https://doi.org/10.1016/j.pec.2025.109203.
Mirzaei-alavijeh M, Hamzeh B, Omrani H, Esmailli S, Khakzad S. Determinants of medication adherence in hemodialysis patients : a cross-sectional study based on capability-opportunity- motivation and behaviour model 2023:1–8.
Yangöz ŞT, Özer Z. Effects of motivational interviewing and an education programme based on Watson’s theory of human caring on adults receiving haemodialysis: randomised controlled trial. Journal of Research in Nursing 2025;30:80–99.
Kaneez M Zubair AB, Rehan M, Hassan A, Sarwar Z, Bibi A, Azhar M, Kinza K, Sabir M. ZSMJ. Sleep Quality and Compliance to Medical Therapy Among Hemodialysis Patients With Moderate-to-Severe Depression: A Cross-Sectional Study. Cureus 2021. https://doi.org/10.7759/cureus.13477.
Zhang Z, Liang X, He X, Zhang X, Tang R, Fang R, et al. Enhancing treatment adherence in dialysis patients through digital health interventions : a systematic review and meta-analysis of randomised controlled trials. Ren Fail 2025;47. https://doi.org/10.1080/0886022X.2025.2482885.
Sirois FM. Procrastination and Stress : A Conceptual Review of Why Context Matters 2023.
Alikari V, Matziou V, Tsironi M, Theofilou P, Giannakopoulou N, Tzavella F, et al. Patient knowledge, adherence to the therapeutic regimen, and quality of life in hemodialysis: knowledge, adherence, and quality of life in hemodialysis. GeNeDis 2020: Geriatrics, Springer; 2021, p. 259–72. https://doi.org/10.1007/978-3-030-78771-4_29.