Intervention strategies to improve compliance with medical regimens by ambulatory hemodialysis patients

Abstract

This research examined the relative efficacies of three intervention strategies designed to increase compliance to medical regimens in a group of ambulatory hemodialysis patients. The interventions examined included behavioral contracting (with or without the involvement of a family member or friend) and weekly telephone contacts with patients. Compliance was assessed with regard to following dietary restrictions and limiting fluid intake. Data were collected from 116 patients drawn from two outpatient clinics. Within clinics, patients were randomly assigned either to an intervention program or to a control group. The study employed a pretest-posttest control group design. Patients were interviewed before the intervention programs began (T₁), after a 6-week intervention period (T₂), and 3 months after completion of the intervention period (T₃). Results showed that the interventions achieved substantial reductions in patients' serum potassium levels and in weight gains between dialysis treatments between T₁ and T₂. In general, however, these program effects tapered off to preintervention levels between T₂ and T₃. The findings thus indicate a need for long-term intervention programs.