A prevalence study on knowledge, attitude, belief and practice of safe medication and analysis of related factors in dialysis patients

doi:10.3969/j.issn.1674-8115.2023.01.011

Abstract

Abstract:

Objective ·To survey the status quo of knowledge, attitude, belief and practice (KAP) of safe medication in the process of medication therapy management in dialysis patients, and analyze the related factors. Methods ·This study was a cross-sectional study with the maintenance dialysis patients selected from the Department of Nephrology, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine from March 2019 to March 2021. The KAP scale for safe medication in patients with chronic kidney disease verified by reliability and validity tests was used to evaluate the status quo of safe medication, and their medication list and clinical characteristics were also investigated. The occurrence of medication-related problems (MRPs) was evaluated according to the Strand classification system. The related factors of KAP level of safe medication in the dialysis patients were analyzed by univariate analysis and multiple linear regression analysis. Results ·A total of 187 maintenance dialysis patients were included, including 103 patients with maintenance hemodialysis (MHD) and 84 patients with continuous ambulatory peritoneal dialysis (CAPD). The mean age of them was (60.19±12.80) years, the mean dialysis duration was (44.31±36.90) months, and the mean numbers of comorbidities and medications were 6.37±2.17 and 7.48±2.66, respectively. In the dialysis patients, the mean score of KAP scale was (77.68±18.53) points. The mean scores of knowledge, attitude, and practice of safe medication were (24.96±8.92), (17.19±3.18), and (35.40±8.18) points, respectively. The univariate analysis results showed that there were significant differences of KAP scores for safe medication in the dialysis pattern, the educational level, the economic level and the occurrence of renal anemia in the maintenance dialysis patients (all P<0.05). In addition, the more comorbidities or medications for regulating calcium and phosphorus metabolism the patients had, or the more MRPs occurred, the lower KAP scores for safe medication the patients got (all P<0.05). Multiple linear regression results showed that the dialysis patients with CAPD (β=8.391, 95%CI 3.436?13.347, P=0.001), with higher education (β=9.159, 95%CI 0.978?17.339, P=0.028), with per capita monthly household income of over 6 000 yuan (β=8.309, 95%CI 1.891?14.727, P=0.011), with less comorbidities (β=-1.582, 95%CI -2.783?-0.382, P=0.010), and with less MRPs (β=-2.284, 95%CI -3.987?-0.581, P=0.009) had higher KAP scores. Conclusion ·The KAP level of safe medication in the patients with maintenance dialysis is low. The hemodialysis, low educational level, low economic level, high number of comorbidities, and high number of MRPs are risk factors for low level of KAP of safe medication in dialysis patients.

Key words: hemodialysis, peritoneal dialysis, safe medication, knowledge, attitude, belief and practice (KAP), medication safety management, health education

CLC Number:

R692.5

WEI Shan, JI Ouyang, CHEN Zhihao, HUANG Zehui, LI Pu, FANG Junyan, LIU Yingli. A prevalence study on knowledge, attitude, belief and practice of safe medication and analysis of related factors in dialysis patients[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(1): 88-94.

Figures/Tables 5

TrendMD

References 21

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Indicator	n （%）	Score/ point	t/F value	P value
Age/year			-0.336	0.737
18‒59	83 （44.39）	77.17±17.97
≥60	104 （55.61）	78.09±19.04
Gender			-0.785	0.433
Male	120 （64.17）	76.88±18.27
Female	67 （35.83）	79.10±19.04
Marital status			-0.920	0.359
Unmarried/divorced/widowed	26 （13.90）	74.58±16.97
Married	161 （86.10）	78.18±18.77
Residence status			0.792	0.430
Living with partner	138 （73.80）	78.32±18.89
Living with kids or parents	49 （26.20）	75.88±17.54
Education level			4.446	0.013
Primary education	29 （15.51）	72.88±25.05
Secondary education	118 （63.10）	76.41±16.99
Higher education	40 （21.39）	84.90±15.67
Per capita monthly family income			10.899	0.000
<3 000 yuan	42 （22.46）	73.74±17.84
3 000‒6 000 yuan	78 （41.71）	72.90±17.80
>6 000 yuan	67 （35.83）	85.72±17.25
Insurance			-2.030	0.056
Social medical insurance	174（93.05）	76.90±18.29
Others	13（6.95）	87.15±19.30

Indicator	n （%）	Score/ point	t/F value	P value
Age/year			-0.336	0.737
18‒59	83 （44.39）	77.17±17.97
≥60	104 （55.61）	78.09±19.04
Gender			-0.785	0.433
Male	120 （64.17）	76.88±18.27
Female	67 （35.83）	79.10±19.04
Marital status			-0.920	0.359
Unmarried/divorced/widowed	26 （13.90）	74.58±16.97
Married	161 （86.10）	78.18±18.77
Residence status			0.792	0.430
Living with partner	138 （73.80）	78.32±18.89
Living with kids or parents	49 （26.20）	75.88±17.54
Education level			4.446	0.013
Primary education	29 （15.51）	72.88±25.05
Secondary education	118 （63.10）	76.41±16.99
Higher education	40 （21.39）	84.90±15.67
Per capita monthly family income			10.899	0.000
<3 000 yuan	42 （22.46）	73.74±17.84
3 000‒6 000 yuan	78 （41.71）	72.90±17.80
>6 000 yuan	67 （35.83）	85.72±17.25
Insurance			-2.030	0.056
Social medical insurance	174（93.05）	76.90±18.29
Others	13（6.95）	87.15±19.30

Indicator	n （%）	Score/ point	t/F value	P value
Dialysis pattern			-4.512	0.000
MHD	103 （55.08）	72.26±14.61
CAPD	84 （44.92）	83.32±20.64
Dialysis age/month			0.748	0.475
<12	31 （16.58）	80.42±19.32
12‒24	26 （13.90）	79.88±21.74
>24	130 （69.52）	76.58±17.68
Renal anemia			2.021	0.045
No	18 （9.63）	86.00±20.97
Yes	169 （90.37）	76.79±18.09
Renal osteodystrophy			1.440	0.152
No	24 （12.83）	82.75±22.04
Yes	163 （87.17）	76.93±17.91
Hypertension			0.017	0.987
No	23 （12.30）	77.74±17.56
Yes	164 （87.70）	77.67±18.71
Coronary heart disease			1.178	0.240
No	99 （52.94）	79.18±19.38
Yes	88 （47.06）	75.99±17.48
Diabetes mellitus			-0.726	0.469
No	134 （71.66）	77.06±17.86
Yes	53 （28.34）	79.25±20.21

Indicator	n （%）	Score/ point	t/F value	P value
Dialysis pattern			-4.512	0.000
MHD	103 （55.08）	72.26±14.61
CAPD	84 （44.92）	83.32±20.64
Dialysis age/month			0.748	0.475
<12	31 （16.58）	80.42±19.32
12‒24	26 （13.90）	79.88±21.74
>24	130 （69.52）	76.58±17.68
Renal anemia			2.021	0.045
No	18 （9.63）	86.00±20.97
Yes	169 （90.37）	76.79±18.09
Renal osteodystrophy			1.440	0.152
No	24 （12.83）	82.75±22.04
Yes	163 （87.17）	76.93±17.91
Hypertension			0.017	0.987
No	23 （12.30）	77.74±17.56
Yes	164 （87.70）	77.67±18.71
Coronary heart disease			1.178	0.240
No	99 （52.94）	79.18±19.38
Yes	88 （47.06）	75.99±17.48
Diabetes mellitus			-0.726	0.469
No	134 （71.66）	77.06±17.86
Yes	53 （28.34）	79.25±20.21

Variable	Value/n	Partial regression coefficient	Standardized regression coefficient	t value	P value
Number of comorbidities	6.37±2.17	-2.378	-2.278	-3.939	0.000
Number of medications	7.48±2.66	0.233	0.033	0.454	0.650
Number of oral tablets	17.30±9.37	0.102	0.052	0.703	0.483
Number of medications for regulating calcium and phosphorus metabolism	1.94±1.23	-2.227	-0.148	-2.040	0.043
Number of anemic medications	1.04±0.65	0.117	0.004	0.055	0.956
Number of MRPs	3.10±1.49	-4.011	-0.323	-4.636	0.000