INTERVENTIONS TO IMPROVE FLUID ADHERENCE AMONG PATIENTS UNDERGOING HEMODIALYSIS: A SYSTEMATIC REVIEW

Abstract

Hemodialysis is the dialysis therapy used more often frequently around the world, however many restrictions of the treatment regimen can lead to the problem of adherence. Education seems to be a promising way to help patients knowing their disease and then develop health behavior to maintain adherence toward hemodialysis treatments regiment although other studies mentioned that education have to combine with other strategic to support adherence behavior improvement among patients undergoing hemodialysis. Better understanding best approach could use to improve adherence especially fluid adherence is necessary in order to minimize the negative effect due to fluid overload. The present review aims to identify trials of intervention applied to improve adherence to fluid intake restrictions imposed on people undergoing hemodialysis. A systematic search of the literature was performed on EBSCHO, PUBMED, OVID, and Cochrane Database of Systematic Review. Study quality was graded according to criteria develop by the authors.Three studies were identified as eligible for inclusion. Relevant information from each included study was extracted and entered into a standardized table, all studies showed an effect of intervention to decrease IDWG. A number of method weaknesses in the existing literature were identified. The results show that multifocal strategic (education, cognitive, and behavioral) have significance effect in reducing IDWG between among patient undergoing hemodialysis. The effectiveness of interventions ranges from moderate to large effect size. This is indicating intervention effectiveness. However, confidence regarding to validity of this finding was susceptibility to bias due to limitation of study. Accordingly, even though those interventions seems likely appropriate and effective to improve fluid adherence, further examination toward effectiveness in more long term evaluation have to considered.