Self-reported Medication Adherence and CKD Progression

CRIC Study Investigators

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: In the general population, medication nonadherence contributes to poorer outcomes. However, little is known about medication adherence among adults with chronic kidney disease (CKD). We evaluated the association of self-reported medication adherence with CKD progression and all-cause death in patients with CKD. Methods: In this prospective observational study of 3305 adults with mild-to-moderate CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study, the baseline self-reported medication adherence was assessed by responses to 3 questions and categorized as high, medium, and low. CKD progression (50% decline in eGFR or incident end-stage renal disease) and all-cause death were measured using multivariable Cox proportional hazards. Results: Of the patients, 68% were categorized as high adherence, 17% medium adherence, and 15% low adherence. Over a median follow-up of 6 years, there were 969 CKD progression events and 675 deaths. Compared with the high-adherence group, the low-adherence group experienced increased risk for CKD progression (hazard ratio = 1.27, 95% confidence interval = 1.05, 1.54) after adjustment for sociodemographic and clinical factors, cardiovascular medications, number of medication types, and depressive symptoms. A similar association existed between low adherence and all-cause death, but did not reach standard statistical significance (hazard ratio = 1.14 95% confidence interval = 0.88, 1.47). Conclusion: Baseline self-reported low medication adherence was associated with an increased risk for CKD progression. Future work is needed to better understand the mechanisms underlying this association and to develop interventions to improve adherence.

Original languageEnglish (US)
Pages (from-to)645-651
Number of pages7
JournalKidney International Reports
Volume3
Issue number3
DOIs
StatePublished - May 1 2018

Fingerprint

Medication Adherence
Chronic Renal Insufficiency
Disease Progression
Cause of Death
Confidence Intervals
Chronic Kidney Failure
Observational Studies
Cohort Studies
Prospective Studies
Depression

Keywords

  • CKD
  • death
  • medication adherence
  • progression

ASJC Scopus subject areas

  • Nephrology

Cite this

Self-reported Medication Adherence and CKD Progression. / CRIC Study Investigators.

In: Kidney International Reports, Vol. 3, No. 3, 01.05.2018, p. 645-651.

Research output: Contribution to journalArticle

CRIC Study Investigators. / Self-reported Medication Adherence and CKD Progression. In: Kidney International Reports. 2018 ; Vol. 3, No. 3. pp. 645-651.
@article{ef8561f79ede4359b0f59fef3e8c5ad4,
title = "Self-reported Medication Adherence and CKD Progression",
abstract = "Introduction: In the general population, medication nonadherence contributes to poorer outcomes. However, little is known about medication adherence among adults with chronic kidney disease (CKD). We evaluated the association of self-reported medication adherence with CKD progression and all-cause death in patients with CKD. Methods: In this prospective observational study of 3305 adults with mild-to-moderate CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study, the baseline self-reported medication adherence was assessed by responses to 3 questions and categorized as high, medium, and low. CKD progression (50{\%} decline in eGFR or incident end-stage renal disease) and all-cause death were measured using multivariable Cox proportional hazards. Results: Of the patients, 68{\%} were categorized as high adherence, 17{\%} medium adherence, and 15{\%} low adherence. Over a median follow-up of 6 years, there were 969 CKD progression events and 675 deaths. Compared with the high-adherence group, the low-adherence group experienced increased risk for CKD progression (hazard ratio = 1.27, 95{\%} confidence interval = 1.05, 1.54) after adjustment for sociodemographic and clinical factors, cardiovascular medications, number of medication types, and depressive symptoms. A similar association existed between low adherence and all-cause death, but did not reach standard statistical significance (hazard ratio = 1.14 95{\%} confidence interval = 0.88, 1.47). Conclusion: Baseline self-reported low medication adherence was associated with an increased risk for CKD progression. Future work is needed to better understand the mechanisms underlying this association and to develop interventions to improve adherence.",
keywords = "CKD, death, medication adherence, progression",
author = "{CRIC Study Investigators} and Cedillo-Couvert, {Esteban A.} and Ricardo, {Ana C.} and Jinsong Chen and Janet Cohan and Fischer, {Michael J.} and Marie Krousel-Wood and Kusek, {John W.} and Swati Lederer and Eva Lustigova and Akinlolu Ojo and Porter, {Anna C.} and Sharp, {Lisa K.} and James Sondheimer and Clarissa Diamantidis and Xue Wang and Jason Roy and Lash, {James P.} and Appel, {Lawrence J.} and Feldman, {Harold I.} and Go, {Alan S.} and Jiang He and Kusek, {John W.} and Lash, {James P.} and Mahboob Rahman and Rao, {Panduranga S.} and Townsend, {Raymond R.}",
year = "2018",
month = "5",
day = "1",
doi = "10.1016/j.ekir.2018.01.007",
language = "English (US)",
volume = "3",
pages = "645--651",
journal = "Kidney International Reports",
issn = "2468-0249",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Self-reported Medication Adherence and CKD Progression

AU - CRIC Study Investigators

AU - Cedillo-Couvert, Esteban A.

AU - Ricardo, Ana C.

AU - Chen, Jinsong

AU - Cohan, Janet

AU - Fischer, Michael J.

AU - Krousel-Wood, Marie

AU - Kusek, John W.

AU - Lederer, Swati

AU - Lustigova, Eva

AU - Ojo, Akinlolu

AU - Porter, Anna C.

AU - Sharp, Lisa K.

AU - Sondheimer, James

AU - Diamantidis, Clarissa

AU - Wang, Xue

AU - Roy, Jason

AU - Lash, James P.

AU - Appel, Lawrence J.

AU - Feldman, Harold I.

AU - Go, Alan S.

AU - He, Jiang

AU - Kusek, John W.

AU - Lash, James P.

AU - Rahman, Mahboob

AU - Rao, Panduranga S.

AU - Townsend, Raymond R.

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Introduction: In the general population, medication nonadherence contributes to poorer outcomes. However, little is known about medication adherence among adults with chronic kidney disease (CKD). We evaluated the association of self-reported medication adherence with CKD progression and all-cause death in patients with CKD. Methods: In this prospective observational study of 3305 adults with mild-to-moderate CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study, the baseline self-reported medication adherence was assessed by responses to 3 questions and categorized as high, medium, and low. CKD progression (50% decline in eGFR or incident end-stage renal disease) and all-cause death were measured using multivariable Cox proportional hazards. Results: Of the patients, 68% were categorized as high adherence, 17% medium adherence, and 15% low adherence. Over a median follow-up of 6 years, there were 969 CKD progression events and 675 deaths. Compared with the high-adherence group, the low-adherence group experienced increased risk for CKD progression (hazard ratio = 1.27, 95% confidence interval = 1.05, 1.54) after adjustment for sociodemographic and clinical factors, cardiovascular medications, number of medication types, and depressive symptoms. A similar association existed between low adherence and all-cause death, but did not reach standard statistical significance (hazard ratio = 1.14 95% confidence interval = 0.88, 1.47). Conclusion: Baseline self-reported low medication adherence was associated with an increased risk for CKD progression. Future work is needed to better understand the mechanisms underlying this association and to develop interventions to improve adherence.

AB - Introduction: In the general population, medication nonadherence contributes to poorer outcomes. However, little is known about medication adherence among adults with chronic kidney disease (CKD). We evaluated the association of self-reported medication adherence with CKD progression and all-cause death in patients with CKD. Methods: In this prospective observational study of 3305 adults with mild-to-moderate CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study, the baseline self-reported medication adherence was assessed by responses to 3 questions and categorized as high, medium, and low. CKD progression (50% decline in eGFR or incident end-stage renal disease) and all-cause death were measured using multivariable Cox proportional hazards. Results: Of the patients, 68% were categorized as high adherence, 17% medium adherence, and 15% low adherence. Over a median follow-up of 6 years, there were 969 CKD progression events and 675 deaths. Compared with the high-adherence group, the low-adherence group experienced increased risk for CKD progression (hazard ratio = 1.27, 95% confidence interval = 1.05, 1.54) after adjustment for sociodemographic and clinical factors, cardiovascular medications, number of medication types, and depressive symptoms. A similar association existed between low adherence and all-cause death, but did not reach standard statistical significance (hazard ratio = 1.14 95% confidence interval = 0.88, 1.47). Conclusion: Baseline self-reported low medication adherence was associated with an increased risk for CKD progression. Future work is needed to better understand the mechanisms underlying this association and to develop interventions to improve adherence.

KW - CKD

KW - death

KW - medication adherence

KW - progression

UR - http://www.scopus.com/inward/record.url?scp=85044256402&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044256402&partnerID=8YFLogxK

U2 - 10.1016/j.ekir.2018.01.007

DO - 10.1016/j.ekir.2018.01.007

M3 - Article

VL - 3

SP - 645

EP - 651

JO - Kidney International Reports

JF - Kidney International Reports

SN - 2468-0249

IS - 3

ER -