Analysis of Antihypertensive Medication Adherence, QoL, and QALY in CKD Patients with Hypertension on Hemodialysis in RSUD RT Notopuro

Abstract

Background: Chronic kidney disease (CKD) patients undergoing hemodialysis (HD) often face challenges that can decrease their quality of life. Adherence to medication, including antihypertensive therapy, is crucial in improving patients' quality of life. Objective: This study aims to analyze the relationship between antihypertensive medication adherence and quality of life (QoL) and Quality Adjusted Life Years (QALY) in Chronic Kidney Disease (CKD) patients with hypertension undergoing hemodialysis at RSUD R.T Notopuro Sidoarjo. Methods: Data were prospectively collected from questionnaires, medical records, pharmacy records, and hospital systems between September-November 2024. A total of 73 patients were selected using purposive sampling. Inclusion criteria included CKD patients aged ≥18 years, undergoing HD, completing the questionnaires, and able to communicate effectively. The HillBone questionnaire was used to assess medication adherence, and the EQ5D5L questionnaire was used to measure quality of life. Data were analyzed using Spearman’s Rho correlation, Mann-Whitney, Chi-Square, independent t-test, and One Way Anova. Results: The majority of respondents were male (61.65%) and aged 51-60 years (45.21%). Of the 73 patients, 70 (95.89%) were non-adherent to antihypertensive medication. The average quality of life score was 0.752, QALY was 25.48, and VAS was 71.3. Significant relationships were found between medication adherence and QoL, utility values, and QALY (P=0.002), as well as between adherence and QoL (P=0.033). Conclusion: The majority of hemodialysis patients at RSUD RT. Notopuro Sidoarjo are non-adherent to antihypertensive medication, with a positive correlation between utility values (EQ5D5L) and QALY. Medication adherence affects patients' quality of life.