Revista de Cuidados Farmacêuticos e Sistemas de Saúde
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A Comparative, Multicenter, Observational Study of Medication Adherence in Liver Cirrhosis Patients and Dialysis Patients Using Electronic Event Measurement

Rita Marina Heeb, Gertrud Greif-Higer, Jens Lutz, Tim Zimmermann, Patrick Harloff, Thomas Mettang, Manfred Berres and Irene Krämer

Introduction: Medication adherence was only studied in a limited number of potential organ recipients. So far medication adherence was not evaluated by utilizing electronic monitoring systems in dialysis and liver cirrhosis patients. The main objective of the present study was to measure the medication adherence of patients suffering from end stage kidney or liver disease by an objectified method.

Methods: Adult liver cirrhosis patients taking propranolol and dialysis patients taking phosphate binders, each medication 3 times daily, were eligible to be enrolled in the study protocol. Medication adherence was measured electronically with MEMS™-containers over a period of 6 months in each patient.

Results: 34 patients suffering from liver cirrhosis and 36 dialysis patients participated in the study and were analysed per protocol. The Dosing Adherence (DA) rate differed significantly (p<0.023) between the two patient groups (mean DA rate of liver cirrhosis patients vs. dialysis patients: 61% vs. 43%).

Conclusion: Low medication adherence rates observed in liver cirrhosis patients and dialysis patients ask for better patient education. Pharmaceutical care programs enhancing adherence should be implemented in both patient groups before transplantation and continued after transplantation.