Development of MERM Model to Improve Medication Adherence to Slow Chronic Kidney Disease Progression among Diabetic Patients with Chronic Kidney Disease Stage 3-4


  • Nealnad Cheyor Consumer Protection and Pharmaceutical Department, Nongjik Hospital, Pattani Province, 94170, Thailand



MEMR Model, Medication Adherence, Slow progression, Diabetes, CKD Stage 3-4


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.


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How to Cite

Cheyor N. Development of MERM Model to Improve Medication Adherence to Slow Chronic Kidney Disease Progression among Diabetic Patients with Chronic Kidney Disease Stage 3-4. Health Sci J Thai [Internet]. 2023 Oct. 12 [cited 2023 Dec. 3];5(4):17-24. Available from:



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