Development of MERM Model to Improve Medication Adherence to Slow Chronic Kidney Disease Progression among Diabetic Patients with Chronic Kidney Disease Stage 3-4
Article Sidebar
Main Article Content
Abstract
This research and development aimed to create a MEMR model and investigate effectiveness of MEMR model development for encouraging medication adherence among diabetic patients with CKD 3-4 in order to slow the progression of chronic kidney disease. The samples consisted of 6 multidisciplinary team members and 68 diabetic patients with CKD 3-4. The data were collected through focus group discussion and medication adherence assessment records. The research was carried out in 3 stages: analyzing stage, model development stage, and evaluation stage. Descriptive statistics, paired t-test, and the McNemar test were used to analyze the data. The findings showed that in the analyzing stage, 80.40% of patients were medication nonadherence and that only 46.09% were slow CKD progression. The MEMR model was developed, which consisted of Meal dose, Education, Monitoring, and Referral. In the evaluation stage, the results revealed that the proportion of the patients with medication adherence and those with slow CKD progression were significantly higher than before the development (p-value<0.001). Increased medication adherence and slowed CKD progression are benefits of the MEMR model. Consequently, it should be used for diabetic patients and other chronic diseases.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
International Diabetes Federation (IDF). Diabetes around the world in 2021. [Internet]. 2021 [Cited in 20 June, 2022]. Available from: https://diabetesatlas.org
Nordheim E and Jenssen T. Chronic kidney disease in patients with diabetes mellitus. Endocr Connect. 2021; 10(5): 151-159.
Brancati FL, Whelton PK, Randall BL, Neaton JD, Stamler J and Klag MJ. Risk of end-stage renal disease in diabetes mellitus: a prospective cohort study of men screened for MRFIT. Multiple Risk Factor Intervention Trial. JAMA. 1997; 278(23): 2069-2074.
Lcks A, Haastert B, Genz J, Giani G, Hoffmann F, Trapp R, et al. Incidence of renal replacement therapy (RRT) in the diabetic compared with the non-diabetic population in a German region, 2002-08. Nephrol Dial Transplant. 2011; 26(1): 264-269.
Kastarinen M, Juutilainen A, Kastarinen H, Salomaa V, Karhapää P, Tuomilehto J, et al . Risk factors for end-stage renal disease in a community-based population: 26-year follow-up of 25,821 men and women in eastern Finland. J Intern Med. 2010; 267(6): 612-620.
Groop P, Arffman M, Kervinen M, Helve J, Riska C, Sund R. Cumulative risk of end-stage renal disease among patients with type 2 diabetes: a nationwide inception cohort study. Diabetes Care. 2019; 42(4); 539-544.
National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes kidney disease. [Internet]. 2017 [Cited in 20 June, 2022]. Available from: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems
United States Renal Data System (USRDS). End stage renal disease. [Internet]. 2023 [Cited in 16 September, 2022]. Available from://usrds-adr.niddk.nih.gov/2022/end-stage-renal-disease
Fox CS , Matsushita K, Woodward M, Bilo H, Chalmers J, Heerspink H, et al. Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis. Lancet. 2012; 380(9854): 1662-1673.
Tancredi M, Rosengren A, Svensson A, Kosiborod M, Pivodic A, Wedel H, et al. Excess mortality among persons with type 2 diabetes. N Engl J Med. 2015; 373(18); 1720-1732.
Kanjanabuch T and Takkavatakarn K. Global dialysis perspective: Thailand. Kidney360. 2020; 1(7): 671-675.
Ismail H, Manaf A, Gafor A, Zaher M, Ibrahim N. International comparisons of economic burden of end-stage renal disease to the national healthcare systems. IMJM. 2019; 18(3): 188-196.
Pattani Provincial Public Health Office. HDC. [Internet]. 2022 [Cited in 30 September, 2022]. Available from: https://www.ptn.moph.go.th/ptn/
Joint Commission of Pharmacy Practitioners (JCPP). The pharmacist’s patient care process. [Internet]. 2022. [Cited in 2 October, 2022]. Available from://https://www.jcpp.net/patient-care-process/
Jongwilaikasem K, Lerkiatbundit S. Development of the medication adherence scale for Thais (MAST). TJPP. 2021; 13(1): 1-14. (in Thai).
Alexandra L, Maria A, Nicolae R. An overview of the common methods used to measure treatment adherence. Med Pharm Rep. 2019; 92(2): 117–122.
Eugene K. Measurements of medication adherence: in search of a gold standard. [Internet]. 2016 [Cited in 24 January, 2023]. Available from: https://www.hmpgloballearningnetwork.com
Al Raiisi F, Stewart D, Fernandez-Llimos F, Salgado T, Mohamed M, Cunningham S. Clinical pharmacy practice in the care of chronic kidney disease patients: a systematic review. Int J Clin Pharm. 2019; 41(3): 630-666.
Cha'on, U, Wongtrangan K, Thinkhamrop B, Tatiyanupanwong S, Limwattananon C, Pongskul C, et al. CKDNET, a quality improvement project for prevention and reduction of chronic kidney disease in the Northeast Thailand. BMC Public Health. 2020; 20(1): 1299
Pantong U. Chronic kidney disease management with chronic care model at primary care in Nakhon Si Thammarat Province. Maharaj Nakhon Si Thammarat Medical Journal 2018; 1(2): 48-58. (in Thai).
Shayakul C, Teeraboonchaikul R, Susomboon T, Kulabusaya B, Pudchakan P. Medication adherence, complementary medicine usage and progression of diabetic chronic kidney disease in Thais. Patient Prefer Adherence. 2022; 16(1): 467-477.
Esteban A, Ana C, Jinsong C, Janet C, Michael J, Marie K, et al. Self-reported medication adherence and CKD progression. Kidney Int Rep. 2018; 3(3): 645-651.
Jasińska-Stroschein M. The effectiveness of pharmacist interventions in the management of patient with renal failure: a systematic review and reta-analysis. Int. J. Environ. Res. Public Health. 2022; 19(18): 11170.