A Systematic Review Of The Prevalence And Determinants Of Nonadherence To Phosphate Binding Medication In Patients With End-stage Renal Disease

Christina Karamanidou; Jane Clatworthy; John Weinman; Rob Horne


BMC Nephrology 

In This Article


Articles were identified for review through the search of online databases PsycINFO (1967–2006), Medline (1950–2006), Embase (1980–2006) and CINAHL (1982–2006). Papers with abstracts containing a combination of three of the terms shown in Table 1 (one from each column) were selected.

The database search resulted in the identification of 481 papers. Three additional papers were identified through a reference list search. Each paper was evaluated by two independent reviewers. Papers were retained if they contained quantitative studies exploring predictors of nonadherence to PB medication in ESRD, were published in English and were available from the British Library. Qualitative studies were excluded because this review aimed to quantify the number of studies reporting a statistically significant relationship versus the number of studies finding no significant relationship between each possible predictor of nonadherence and nonadherence. Papers were also excluded if they focused on paediatric adherence (patients under 18 years old), were review articles, intervention studies or case studies, or contained secondary analyses on data already included in this review.

The two reviewers extracted information on the rates of nonadherence reported and the predictors of nonadherence explored in each paper. A list of all the variables that had been investigated in relation to nonadherence was compiled. These possible predictors of nonadherence were divided into three categories: demographic, clinical and psychosocial. The number of studies reporting a significant relationship (p <.05) between each variable and nonadherence and the number of studies reporting no significant relationship (p >.05) between each variable and nonadherence were recorded.


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