Exploring the Role of Healthcare Management in improving patient adherence to End Stage Renal Disease Treatment the Case of Pietersburg Renal Dialysis Unit

Thema MG and Marutla GB

Published on: 2024-05-02

Abstract

End-Stage Kidney Disease (ESKD) is a global health and healthcare burden that is rapidly increasing. The growing number of ESRD patients necessitates dialysis management for better outcomes and well-being; thus, adherence to prescribed treatment is critical. Adherence is a major issue in chronic kidney disease patients. Patients may be disobedient to various aspects of their treatment regimen, such as medications, dialysis, dietary and fluid restrictions. As a result, healthcare management intervention is required to increase patient adherence to the ESRD treatment regimen.

The purpose of this study was to explore how healthcare management can play a role in improving adherence to ESRD treatment regimens among patients in Pietersburg Hospital, in Limpopo Province. A qualitative method approach was used. An exploratory case study design was used where qualitative data was collected in the form of questionnaires and semi-structured interview schedules. The data collected was to explore the perceptions of healthcare management regarding their role in managing patient adherence and the effectiveness of the existing programmes in ensuring patient adherence. Non- probability -Purposive sampling was used in selecting participants for the questionnaire and interviews. For the questionnaires, a total sample of 15 participants was selected and for the semi-structured interview schedule, a total sample of 15 participants was selected. Descriptive analysis using “measures of frequency” to develop a percentage was used to analyse the data collected through questionnaires. A thematic framework approach and Atlas.ti version 9.0 was used to analyse data collected through interviews. The institutional management theories such as Systems theory, Contingency theory, and Resource theory were used to guide the study.

The study’s participants' ages ranged between 32-60+. The following key challenges faced by renal patients in attending their dialysis treatment were identified, 12(63%) transport, 10(52%) distance, 4(21%) financial problems, 3(16%) time -Allocated slots, and 2(11%) for lack of support from families. The following 5 themes with their sub- themes were discovered from the analysis of the transcripts, challenges of non- adherence, perceptions of healthcare management regarding their role, governance role of public health management, organisational factors, strategies, and recommendations.

Adherence to treatment regimens by renal patients is important, and healthcare management can play a role in improving the adherence of ESRD patients to treatment regimens by implementing the suggested recommendations. More studies are needed to explore the unit costs of hospitalisation of renal patients due to non- adherence to treatment and the benefits of decentralisation of nephrology treatment.