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Table 2 Details of the studies included in the review

From: A systematic review of the prevalence and determinants of nonadherence to phosphate binding medication in patients with end-stage renal disease

Study N Dialysis type Mean age (years) Mean time on dialysis (months) Gender % male Main statistical analysis Predictors of adherence Adherence assessment Non-adherence definition % Non-adherent
       Demographic Clinical Psychosocial    
Bame et al, 1993 U.S. [12] 1230 HD 57 Not stated 47% Multiple logistic regression Age*, income*, gender, ethnicity, marital status, education Not assessed Not assessed Serum phosphorus >6 mg/dl 50%
Betts & Crotty, 1988 U.S.[42] 46 HD Not stated Not stated 33% Correlations Age, education Time on dialysis Response to illness Serum phosphorus > 5 mg/dl 74%
Blanchard et al, 1990 U.S.[38] 40 HD 40 PD 50 Not stated 48% Correlations Gender Time on dialysis Not assessed Self report Reporting ever missing a dose 28%
Boyer et al, 1990 U.S.[13] 60 HD Not stated Not stated 71% Correlations, multiple regression Age*, marital status*, gender, ethnicity, income, education Time on dialysis Social support* Serum phosphorus Not dichotomised Not stated
Christensen et al, 1994 U.S.[14] 52 HD 34 PD 49 73 53% Hierarchical regression Age**, gender, marital status, education Diabetic status, time on dialysis, transplant history, type of dialysis Information vigilance, active coping Serum phosphorus Not dichotomised Not stated
Christensen et al, 1995 U.S.[15] 72 HD or PD 46 73 54% Correlations, stepwise regression Age*, education Time on dialysis, transplant history Neuroticism, extraversion, openness to experience, agreeableness, conscientiousness* Serum phosphorus Not dichotomised Not stated
Christensen et al, 1996a U.S.[44] 52 HD 59 62 59% Regression Age, education, gender Diabetic status, time on dialysis Neuroticism, private body consciousness, illness related physical impairment Serum phosphorus Not dichotomised Not stated
Christensen et al, 1996b U.S. [16] 67 HD 14 PD 55 70 49% Regression Age **, education, gender Diabetic status*, type of dialysis, time on dialysis Perceived health competence*, health locus of control Serum phosphorus Not dichotomised Not stated
Christensen et al, 1997a U.S.[33] 51 HD 57 51 59% Correlation, hierarchical regression Age, education, gender Diabetic status, time on dialysis Monitoring attentional style, trait anxiety, internal health locus of control, control appraisal, avoidant coping Serum phosphorus Not dichotomised Not stated
Christensen et al, 1997b U.S.[43] 48 HD 56 65 54% Correlations, hierarchical regression Age, education, gender Diabetic status, time on dialysis Cynical hostility*, health locus of control Serum phosphorus Not dichotomised Not stated
Cummings et al, 1982 U.S.[22] 116 HD 55 29 54% Correlations, regression Age*, gender, income, education Time on dialysis, transplant history, regimen complexity* Susceptibility, severity, benefits*+, barriers+, knowledge of purpose of regimen*, social support (family and friends), support from medical staff+, family problems+ Serum phosphorus Self report >5.5 mg/dl 70% (based on serum phosphorus)
Curtin et al, 1999 U.S.[49] 135 HD 63 Not stated 47% Chi-square Ethnicity###, age, gender, employment status, education Cause of renal failure, no. comorbidities, time on dialysis Not assessed Electronic monitoring (used in analysis)
Pill count
Self report
Overdosing/underdosing/missing more than 20% prescribed doses 73% (based on electronic monitoring)
Eitel et al, 1998 U.S.[27] 40 HD 45 PD 55 40 61% Correlations Not assessed Not assessed Efficacy expectations**, effort attributions, self control Serum phosphorus (used in analysis)
Self report
Staff ratings
Not dichotomised Not stated
Gago et al, 2000 Spain[35] 121 HD 63 37 56% T-tests Gender, age, living arrangements Cause of ESRD, time on dialysis Knowledge Not clear Not clear 46%
Hilbert, 1985 U.S.[29] 26 HD 47 54 35% Correlations, ANOVA Age, income, education, social class, religion, gender, significant other No. times hospitalised, time on dialysis+ Directive guidance social support+, affection social support Composite self report scale – adherence to medication, fluid and diet (used in analysis) Serum phosphorus Not dichotomised Not stated
Horne et al, 2001 U.K.[17] 47 HD 49 53 49% Correlations Age+, gender, education Duration of ESRD, time on dialysis, no. prescribed medicines Beliefs about medication (concerns ++, perceived need, harm, overuse) Self report Those who reported sometimes, often or very often deliberately missing a dose of their medication. 26%
Leggat et al, 1998 U.S.[18] 6251 HD 58 54 50% Logistic regression Age***, ethnicity*, smoker*, gender, education, living arrangements Time on dialysis, diabetic status, transplant history Not assessed Serum phosphorus >7.5 mg/dl 22%
Lin & Liang, 1997 China[39] 86 HD 55 42 45% Correlations Not assessed Not assessed Health locus of control+++, ** 3 composite measures: Lab reports (including serum phosphorus)
Self report – fluid, diet and medication adherence
Nurses' assessment – fluid, diet and medication adherence
>4.59 mg/dl 61% (based on serum phosphorus)
Moran et al, 1997 U.S.[45] 56 HD 57 46 64% Regression Age, gender, education Time on dialysis, diabetic status, transplant history** Social support, conscientiousness Serum phosphorus Not dichotomised Not stated
Morduchowicz et al, 1993 Israel[46] 50 HD 56 66 60% Multivariate and stepwise regression Education ***, ethnicity*, gender, age, place of birth, religious observance, marital status, no. children, whether accompanied to session, economic status, living arrangements Previous PD dialysis, time on dialysis Not assessed Serum phosphorus Not dichotomised Not stated
O'Brien, 1980 U.S.[28] 63 HD Not stated Not stated 54% ANOVA, correlations, regression Age, gender, marital status++, ethnicity, education, occupation, type of household Time on dialysis Significant others' expectations regarding adherence+++ Composite self report scale – dialysis attendance, diet, fluid and medication Not stated Not stated
Reiss et al, 1986 U.S.[47] 23 HD 48 8 57% Correlations Family income, marital status, years married, family size, education Not assessed Problem solving (coordination and closure), family intelligence Serum phosphorus Not dichotomised Not stated
Schlebusch & Levin, 1982 South Africa[34] 25 HD or PD 38 Not stated 48% Mann-Whitney test Not assessed Organicity (cortical dysfunction)$ Intelligence, personality$$ Composite staff rating – including adherence to medication and diet Not stated 44%
Schneider, 1992 U.S.[19] 137 HD 51 26 54% Multiple regression Age***, gender, ethnicity, education Time on dialysis, frequency of physician contact Health locus of control*** Serum phosphorus Not dichotomized Not stated
Sherwood, 1983 U.S.[30] 55 HD 46 48 66% Correlations Not assessed Not assessed Family understanding, family organisation*, supportive family**,+++ Serum phosphorus Composite self-report measure – diet, fluid and medication Not stated Not stated
Stamatakis et al, 1997 U.S.[20] 17 HD
4 PD
53 Not stated 48% Anova, chi-square, multiple regression Age*, gender, ethnicity education, occupation, marital status Type of dialysis, cause of ESRD, transplant history Knowledge* Serum phosphorus Self report Not stated Not stated
Steidl et al, 1980 U.S.[31] 22 HD
1 PD
43 22 57% Correlations Not assessed Medical assessment Family functioning$$$ Composite staff assessment – dialysis attendance/medication and diet adherence Not stated Not stated
Takaki et al, 2003 Japan[21] 484 HD 60 98 66% Correlations, multiple regression Age***, gender Time on dialysis*** Not assessed Serum phosphorus Not dichotomised Not stated
Tomasello et al. 2004 U.S.[3] 129 HD 59 PD 60 46 Not stated ANOVA Age Time on dialysis, diabetic status, tablet burden* Not assessed Self report
Serum phosphorus
Reporting taking less than 80% medication as prescribed
>5.5 mg/dl
38% (based on self report) 51% (based on serum phosphorus)
Tracy et al, 1987 U.S.[40] 15 HD 52 0 (starting dialysis) 67% Correlations, ANOVA Not assessed Not assessed Personality*, depression*, family environment Composite measure – serum phosphorus and interdialytic weight Not stated Not stated
Vives et al, 1999 Spain[41] 31 HD 63 35 74% Mann Whitney, Wilcoxon, T-test Age, gender Duration of treatment Health locus of control Composite score based on serum phosphorus, serum potassium and interdialytic weight >6.01 mg/dl Not stated
Weed-Collins & Hogan, 1989 U.S.[26] 30 HD Not stated Not stated 43% Correlations Not assessed Not assessed Knowledge of phosphate binders, susceptibility, severity, benefits, barriers* Serum phosphorus >5.5 mg/dl 64%
Wenerowicz et al, 1978 U.S.[37] 19 HD 36 7 68% Chi-square, t-test Not assessed Not assessed Health locus of control * Serum phosphorus >4.5 mg/dl 68%
Wiebe & Christensen, 1997 U.S.[48] 70 HD 56 141 60% Stepwise, hierarchical regression Age, gender, education, marital status Diabetic status, time on dialysis Conscientiousness, susceptibility, severity, benefits, barriers Serum phosphorus Not dichotomised Not stated
  1. Note: HD = hemodialysis, PD = peritoneal dialysis, ESRD = End stage renal disease
  2. * p < 0.05 **p < 0.01 ***p < 0.001 relationship with serum phosphorus levels, + p < 0.05 ++p < 0.01 +++p < 0.001 relationship with self report adherence, # p < 0.05 ##p < 0.01 ###p < 0.001 relationship with electronic monitoring, $p < 0.05 $$ < 0.01 $$$p < 0.001 relationship with staff ratings of adherence