Prevalence and Predictors of Nonadherence to Treatment in Adult Patients Undergoing In-Centre Haemodialysis in Public Dialysis Units: A Quantitative Cross-Sectional Study

BackgroundNonadherence to treatment regimens is common among patients on maintenance haemodialysis and has been well studied internationally and regionally; however, a local gap remains.AimThis study aimed to determine the prevalence and predictors of treatment nonadherence among adults receiving in-centre haemodialysis in Bahrain’s public units.DesignA cross-sectional design.ParticipantsA total of 266 patients receiving haemodialysis were recruited from two public haemodialysis units using simple random sampling conducted independently within each study centre.Measurements InstrumentEnd Stage Renal Disease Adherence Questionnaire, demographics and clinical examination and laboratory results sheet.ResultsThe nonadherence rate to haemodialysis prescription was 85%, with 81.9% shortening sessions and 15.1% missing sessions in the previous month. Medication, fluid and dietary nonadherence rates were 18%, 29.3% and 20.6%, respectively. Bivariate analysis showed that participants aged > 60 years had better adherence to fluid restriction (p=0.031) and medications (p=0.006), while those treated at Centre A demonstrated higher adherence to haemodialysis prescriptions (p=0.001) and medication therapy (p=0.034). Regression model identified age as an independent predictor of medication adherence; participants aged > 60 years had 2.74 higher odds of adherence compared with those aged ≤ 60 years (p=0.004). Participants attending Centre B had 53% lower odds of medication adherence than those at Centre A (p=0.045). Accompanying participants, transportation issues and receipt of health education were not significantly associated with adherence across treatment domains.ConclusionNonadherence to haemodialysis treatment regimens varied across treatment domains among the study population. Healthcare providers in Bahrain’s public haemodialysis units should consider adherence behaviours and associated factors during patient assessment and follow-up. Further studies are required to better understand treatment nonadherence among haemodialysis patients in public dialysis units and in Bahrain.