Evaluation of the pharmacotherapy profile and adherence to pharmacotherapy by patients at a hemodialysis service in Southern Brazil: A Cross-sectional study
DOI:
https://doi.org/10.30968/jhphs.2026.172.1431Abstract
Objectives: To estimate the prevalence of low pharmacotherapy adherence, as assessed by the Brief Medication Questionnaire (BMQ), and to investigate its association with polypharmacy, cognitive status, and sources of access to medications among patients undergoing hemodialysis. Methods: A cross-sectional study with prospective data collection was conducted in the hemodialysis unit of a teaching hospital in Caxias do Sul, Rio Grande do Sul, Brazil, between May and December 2022, with consecutive inclusion of eligible patients. Adherence-related behaviors were assessed using the BMQ and classified as High/Probable high or Low/Probable low pharmacotherapy adherence. Polypharmacy was defined as the use of ≥5 home medications. Cognitive status was assessed using the Mini-Mental State Examination, with education-adjusted cutoff scores. Sources of access to medications were categorized according to the mode of acquisition. Categorical variables were described as n (%) and compared between groups using Pearson’s chi-square test or Fisher’s exact test, adopting p<0.05. Results: Of the 109 patients assessed for eligibility, 105 met the criteria and 98 were included in the analysis. The prevalence of Low/Probable low adherence was 84.7%. The mean number of home medications was 5.0 (±2.5), and 57.1% of patients had polypharmacy. No association was observed between cognitive status and adherence (OR=1.04; 95% CI: 0.34–3.20; p=1.00). Polypharmacy was associated with higher odds of Low/Probable low adherence (OR=3.19; 95% CI: 1.00–10.18; p=0.005). Use of phosphate binders was also associated with higher odds of Low/Probable low adherence (OR=11.26; 95% CI: 1.41–89.63; p=0.008). The number of sources of access to medications was not associated with adherence (p=0.305). The most prevalent comorbidities were hypertension and diabetes. Conclusion: A high frequency of Low/Probable low pharmacotherapy adherence was observed among patients undergoing hemodialysis. Polypharmacy and regimen-related factors, particularly in the BMQ recall and regimen domains, were associated with this profile. These findings reinforce the relevance of multidisciplinary strategies aimed at treatment simplification and support for appropriate medication use.
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