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Abstract
Pain is one of the most common symptoms among patients with end-stage renal disease (ESRD), and is often under recognized and not adequately managed in hemodialysis (HD) patients. Barriers to adequate pain management include poor awareness of the problem, insufficient medical education, fears of possible drug-related side effects, and common misconceptions about the inevitability of pain in elderly and HD patients. Caregivers working in HD should be aware of the possible consequences of inadequate pain assessment and management. Common pain syndromes in HD patients include musculoskeletal diseases and metabolic neuropathies, associated with typical intradialytic pain. Evaluating the etiology, nature, and intensity of pain is crucial for choosing the correct analgesic. A mechanism-based approach to pain management may result in a better outcome. Pharmacokinetic considerations on clearance alterations and possible toxicity in patients with ESRD should drive the right analgesic prescription. Comorbidities and polymedications may increase the risk of drug-drug interactions, therefore drug metabolism should be taken into account when selecting analgesic drugs. Automedication is common among HD patients but should be avoided to reduce the risk of hazardous drug administration. Further research is warranted to define the efficacy and safety of analgesic drugs and techniques in the context of patients with ESRD as generalizing information from studies conducted in the general population could be inappropriate and potentially dangerous. A multidisciplinary approach is recommended for the management of complex pain syndromes in frail patients, such as those suffering from ESRD.
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Affiliation(s)
- Flaminia Coluzzi
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy.
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Rezaei Z, Jalali A, Jalali R, Khaledi-Paveh B. Psychological problems as the major cause of fatigue in clients undergoing hemodialysis: A qualitative study. Int J Nurs Sci 2018; 5:262-267. [PMID: 31406835 PMCID: PMC6626205 DOI: 10.1016/j.ijnss.2018.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 04/23/2018] [Accepted: 07/04/2018] [Indexed: 11/24/2022] Open
Abstract
Background It is obvious that hemodialysis is a stressful process, leading to numerous social and psychological problems, and may cause fatigue and helplessness. Objective This study aimed to explain the experiences of hemodialysis clients regarding the effect of psychological problems on fatigue. Methods This article was extracted from a qualitative study conducted on clients undergoing hemodialysis in Khorramabad. To this end, a total of 15 participants were purposefully selected using the snowball sampling method and the required data was collected using individual, face to face, detailed and semi-structured interviews. There were 12 client interviewees and one doctor, one nurse and one hemodialysis client's spouse. Content analysis was used to analyze the data. Results Continuous analysis of data and documents obtained from the interviews on the hemodialysis clients' experiences and comments regarding the main causes of fatigue revealed two main categories: 1) Psychological effects with subcategories of psychological stress and exhaustion; 2) Needs and constraints with subcategories of individual and social needs and constraints. Conclusion According to the clients' speech and expression analysis, psychological impacts and disease-induced needs and constraints were the most important cause of fatigue and its continuation among these clients.
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Affiliation(s)
- Zahra Rezaei
- Student Research Committee, School of Nursing and Midwifery, Kermanshah University of medical sciences, Kermanshah, Iran
| | - Amir Jalali
- Psychiatric Nursing Department, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Rostam Jalali
- Nursing Department, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behnam Khaledi-Paveh
- Psychiatric Nursing Department, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Adherence to Hemodialysis and Associated Factors among End Stage Renal Disease Patients at Selected Nephrology Units in Rwanda: A Descriptive Cross-Sectional Study. Nurs Res Pract 2018; 2018:4372716. [PMID: 29973988 PMCID: PMC6008892 DOI: 10.1155/2018/4372716] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 03/17/2018] [Accepted: 04/03/2018] [Indexed: 11/22/2022] Open
Abstract
Introduction Worldwide, End Stage Renal Disease (ESRD) has become a public health concern increasing the number of patients maintained on hemodialysis prior to renal transplantation. Nonadherence to hemodialysis continues to impact on the care of ESRD patients, causing high increase in morbidity and mortality. Purpose of the Study The purpose of this study was to determine the level of adherence to hemodialysis and the associated factors among End Stage Renal Disease (ESRD) patients in selected nephrology units in Rwanda. Methods This was a descriptive cross-sectional design involving 41 participants. Participants were recruited using a purposive sampling technique. Demographic and adherence to hemodialysis data were collected with the use of structured interview schedules. Descriptive statistics were used to describe the demographic variables and the level of adherence to hemodialysis. Inferential statistics of chi-square was used to establish factors associated with adherence to hemodialysis. Results Twenty-one (51%) of ESRD participants adhered highly (scores < 80%) to HD. Seventeen (42%) adhered moderately (70–79%) to HD while three (7%) had low level of adherence to HD (below 70%). The factors associated with adherence to hemodialysis were age (mean = 27; 95% CI 26.76–29, 17; p = 038) and religion (95% CI 26.29–60.12, p = 003). Frequencies of education of health care workers about the importance of not missing dialysis (95% CI 26.71–42.56, p = .000), perceived relative importance of hemodialysis (95% CI 20.44–27.76, p = .020), and experiencing difficulties during the procedure (95% CI 20.80–28.36, p = .004) were significantly associated with adherence to hemodialysis. Conclusion. Adherence to hemodialysis is still a public health concern in Rwanda. Health care providers and particularly nurses should continue to advocate for adherence to HD for better health outcomes. Further research is needed to identify the barriers to HD in Rwanda.
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Mousa I, Ataba R, Al-ali K, Alkaiyat A, Zyoud SH. Dialysis-related factors affecting self-efficacy and quality of life in patients on haemodialysis: a cross-sectional study from Palestine. RENAL REPLACEMENT THERAPY 2018. [DOI: 10.1186/s41100-018-0162-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Khatib ST, Hemadneh MK, Hasan SA, Khazneh E, Zyoud SH. Quality of life in hemodialysis diabetic patients: a multicenter cross-sectional study from Palestine. BMC Nephrol 2018; 19:49. [PMID: 29490623 PMCID: PMC5831192 DOI: 10.1186/s12882-018-0849-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 02/20/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Both diabetes and hemodialysis can seriously impair patients' health related quality of life (HRQOL). This study seeks to obtain data which will help to address the factors associated with impaired HRQOL in hemodialysis patients with diabetes in Palestine. METHODS A cross-sectional study was performed in multiple centers in the period from November 2016 to June 2017. We utilized the Arabic version of EuroQoL 5 Dimensions 5 Levels (EQ-5D-5L) scale and EuroQol-visual analogue scale (EQ-VAS) to measure patients' HRQOL. The study was conducted in six dialysis centers in the North of West Bank, Palestine. Descriptive and comparative statistics were used to describe clinical and socio-demographic features of patients. Multiple linear regression analysis was used to determine the association between clinical and socio-demographic factors and HRQOL score. RESULTS One hundred and forty one diabetic patients undergoing hemodialysis were enrolled in our study. Overall, 52.5% of them (74 patients) were males; the patients had a mean age of 60.32 with 52.5% of them aged below 60. The mean ± standard deviation of EQ-5D-5L index and EQ-VAS score was 0.314 ± 0.4 and 50.85±22.43, respectively. The findings of this study suggest that female patients, uneducated patients, unemployed patients, unmarried patients, and patients with more chronic diseases and comorbidities had a significant poor HRQOL scores (p values <0.05). Variables such as marital status and occupational status were significantly (p < 0.05) associated with the QOL score. More specifically, married status and employed patients positively associated with QOL score (β = 0.22; p = 0.016 and β = 0.27; p = 0.013, respectively). CONCLUSIONS Among diabetic patients undergoing hemodialysis, married status and being employed were associated with modestly higher scores of QOL. We recommend that healthcare providers give more attention to diabetic dialysis patients who are unemployed and unmarried, as they are at a higher risk of having impaired HRQOL.
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Affiliation(s)
- Sohaib T. Khatib
- 0000 0004 0631 5695grid.11942.3fDepartment of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Mohammad K. Hemadneh
- 0000 0004 0631 5695grid.11942.3fDepartment of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Samer A. Hasan
- 0000 0004 0631 5695grid.11942.3fDepartment of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Emad Khazneh
- 0000 0004 0631 5695grid.11942.3fNephrology Unit, Internal Medicine Department, An-Najah National University Hospital, An-Najah National University, Nablus, 44839 Palestine
| | - Sa’ed H. Zyoud
- 0000 0004 0631 5695grid.11942.3fPoison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- 0000 0004 0631 5695grid.11942.3fDepartment of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
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Ramatillah DL, Syed Sulaiman SA, Khan AH, Meng OL. Quality of Life among Patients Undergoing Hemodialysis in Penang, Malaysia. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2017; 9:229-238. [PMID: 29456373 PMCID: PMC5810072 DOI: 10.4103/jpbs.jpbs_191_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Quality of life is one of the parameters to check the improvement of hemodialysis treatment among hemodialysed patients. Those patients will be dealing with this treatment in long term if this treatment is the only way for them to replace their kidney function and this thing will affect their quality of life. OBJECTIVE To evaluate the quality of life patients on hemodialysis using kidney disease quality of life-short term 24 (KDQoL-SF24) Malaysian Version. MATERIALS AND METHODS Cohort observational study was conducted in this study. The study included 78 hemodialysed patients in HD center Penang, Malaysia. RESULTS There were 9 components which had the lower of the mean and standard deviation (SD) than the standard form; work status (15.01 ± 35.57), cognitive function (75.66 ± 13.75), quality of life social interaction (76.32 ± 16.11), sleep (55.86 ± 15.30), social support (59.61 ± 22.08), patient satisfaction (43.24 ± 15.32), physical functioning (50.06 ± 42.81), general health (29.62 ± 25.56), and role emotional (54.27 ± 49.92). In this HD center, the group of patient's age who had the lower mean ± SD from the KDQoL-SF Manual Standard were the first and the sixth groups of patient's age (≤20 and 61-70). CONCLUSION The study conducted in HD center, Penang, Malaysia showed that the scoring of work status, cognitive function, quality of social interaction, sleep, social support, patient satisfaction, physical functioning, general health, and role emotional were low than standard form.
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Affiliation(s)
- Diana Laila Ramatillah
- Department Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Syed Azhar Syed Sulaiman
- Department Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Amer Hayat Khan
- Department Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Ong Loke Meng
- Department Nephrology, Physician in Nephrology and Hemodialysis Ward at General Hospital Penang, Penang, Malaysia
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Ahmadzadeh S, Matlabi H, Allahverdipour H, Khodaei Ashan S. The effectiveness of self-management program on quality of life among haemodialysis patients. PROGRESS IN PALLIATIVE CARE 2017. [DOI: 10.1080/09699260.2017.1345407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sharareh Ahmadzadeh
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Matlabi
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Allahverdipour
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
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Naalweh KS, Barakat MA, Sweileh MW, Al-Jabi SW, Sweileh WM, Zyoud SH. Treatment adherence and perception in patients on maintenance hemodialysis: a cross - sectional study from Palestine. BMC Nephrol 2017; 18:178. [PMID: 28558719 PMCID: PMC5450383 DOI: 10.1186/s12882-017-0598-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 05/19/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Adherence to diet recommendations, fluid restriction, prescribed medications, and attendance at hemodialysis (HD) sessions are essential for optimal and effective treatment of patients with end-stage renal disease. No data regarding this issue are available from Palestine. Therefore, this study was carried out to assess adherence to diet, fluid restriction, medications, and HD sessions. METHODS A cross-sectional study of HD patients at An-Najah National University Hospital was carried out during summer, 2016. Self-reported adherence behavior was obtained using a valid and reliable questionnaire (End-Stage Renal Disease Adherence Questionnaire: ESRD-AQ). Predialytic serum levels of potassium and phosphate were obtained as clinical indicator of diet and medication adherence respectively. In addition, interdialytic body weight (IDW) was also obtained from medical records and analyzed in relation to reported adherence of fluid restriction. RESULTS A total of 220 patients answered all questions pertaining to ESRD-AQ. The mean age ± standard deviation of participants was 56.82 ± 14.51 years. Dietary adherence was observed in 24% while that of fluid restriction adherence was observed in 31% of studied patients. Reported adherence to HD sessions was 52% while that for medications was 81%. Overall, 122 (55.5%) patients had good adherence, 89 (40.5%) had moderate adherence, and 9 (4.1%) had poor adherence behavior. Male patients had significantly higher overall adherence scores than females (p = 0.034). A significant correlation between reported diet adherence and serum pre-HD potassium level (p < 0.01) was observed. A significant correlation between reported fluid restriction adherence and IDW (p < 0.01) was also found. However, no significant correlation between reported adherence and pre-HD phosphate level. There was significant correlation between overall perception and overall adherence score (p < 0.001). Counselling of patients regarding importance of adherence modalities was lowest for "staying for the entire dialysis time". Multivariate analysis indicated that elderly male patients who were city residents had higher odds of having higher adherence score. CONCLUSIONS There was a good percentage of patients who had overall moderate or poor adherence. ESRD-AQ could be used to assess some aspects of HD adherence. Counselling and education of patients on HD are important to improve therapeutic outcome.
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Affiliation(s)
- Karam Sh. Naalweh
- 0000 0004 0631 5695grid.11942.3fDepartment of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Mohammad A. Barakat
- 0000 0004 0631 5695grid.11942.3fDepartment of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Moutaz W. Sweileh
- 0000 0004 0631 5695grid.11942.3fDepartment of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Samah W. Al-Jabi
- 0000 0004 0631 5695grid.11942.3fDivision of Clinical and Community Pharmacy, Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Waleed M. Sweileh
- 0000 0004 0631 5695grid.11942.3fDepartment of Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Sa’ed H. Zyoud
- 0000 0004 0631 5695grid.11942.3fDivision of Clinical and Community Pharmacy, Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- 0000 0004 0631 5695grid.11942.3fPoison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
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Abu Farha NH, Khatib MT, Salameh H, Zyoud SH. Cancer-related post-treatment pain and its impact on health-related quality of life in breast cancer patients: a cross sectional study in Palestine. ASIA PACIFIC FAMILY MEDICINE 2017; 16:7. [PMID: 29200943 PMCID: PMC5696967 DOI: 10.1186/s12930-017-0037-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 11/15/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Post-treatment pain has been suggested as an important indicator for health-related quality of life (HRQOL) in patients with breast cancer. Therefore, this study was performed to examine the association between pain and its impact on HRQOL among breast cancer patients in Palestine. Also, this study aimed to determine the QOL profile for breast cancer patients and stated the factors associated with QOL. METHODS A correlational cross-sectional study was conducted from May 2016 to November 2016 at Al-Watani Hospital and An-Najah National University Hospital in the Nablus district in Palestine. The five-level EuroQol five-dimensional instrument (EQ-5D-5L) was used to examine HRQOL. Pain severity and interference were assessed using the Brief Pain Inventory (BPI). Multiple linear regression analysis was performed to determine the most important variables related with HRQOL. RESULTS One hundred and seventy patients were involved in this study. Overall, all participants were female, with a mean ± SD for age of 51.71 ± 11.11 years. The reported HRQOL of this study was measured by using the median EQ-5D-5L index score, which was 0.67 (interquartile range: 0.51-0.84). There were moderate negative correlations between EQ-5D-5L index score and pain severity score (r = - 0.58, p value < 0.001), and pain interference score (r = - 0.604, p-value < 0.001). Furthermore, univariate analysis showed that age, marital status, employment status, income, current condition of cancer, and post-treatment pain were associated with quality of life (p-value < 0.05). Regression analysis revealed that patients with high income (p-value = 0.003), patients with lower pain severity score (p-value < 0.001), and lower pain interference score (p-value = 0.018) were independently associated with high QOL. CONCLUSIONS This is the first study to present important data regarding QOL by using the EQ-5D-5L instruments that may help healthcare providers to identify patients at risk of low QOL. Healthcare providers and health strategy makers should be alerted to low level HRQOL among breast cancer patients with low income level, patients with post-treatment pain, especially in the state of severe pain, and the state of pain interfering with daily life to improve their HRQOL.
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Affiliation(s)
- Nader H. Abu Farha
- 0000 0004 0631 5695grid.11942.3fDepartment of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Mohammed T. Khatib
- 0000 0004 0631 5695grid.11942.3fDepartment of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Husam Salameh
- 0000 0004 0631 5695grid.11942.3fDepartment of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Sa’ed H. Zyoud
- 0000 0004 0631 5695grid.11942.3fPoison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- 0000 0004 0631 5695grid.11942.3fDivision of Clinical and Community Pharmacy, Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
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Pasalar M, Akrami R. Excessive Attention to Major Complications in Frequent Dialysis: A Misleading Point for Patients' Quality of Life? Ther Apher Dial 2016; 20:537-538. [PMID: 27630062 DOI: 10.1111/1744-9987.12459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Mehdi Pasalar
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Rahimeh Akrami
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Traditional Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Zyoud SH, Al-Jabi SW, Sweileh WM, Tabeeb GH, Ayaseh NA, Sawafta MN, Khdeir RL, Mezyed DO, Daraghmeh DN, Awang R. Use of complementary and alternative medicines in haemodialysis patients: a cross-sectional study from Palestine. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 16:204. [PMID: 27400742 PMCID: PMC4940841 DOI: 10.1186/s12906-016-1196-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 07/07/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Complementary and alternative medicine (CAM), and herbal therapies, are accepted worldwide, and have been important from medical, sociological and economic perspectives, among haemodialysis (HD) patients. The primary aim of this study was to evaluate the use of CAM among patients with end-stage renal disease (ESRD) who are undergoing HD. METHODS Face-to-face interviews of patients with ESRD undergoing HD from ten outpatient renal departments at a national level in Palestine were conducted from June 2014 to January 2015. A survey questionnaire, which included questions on socio-demographic and clinical characteristics, and on the CAM therapies that were used, was administered. RESULTS Out of 267 patients interviewed, 172 patients used at least one type of CAM in the last month prior to the interview, and thus the utilisation rate was 64.4 %. Forty one (15.4 %) patients reported using one type of CAMs, while 18.7 % used two different CAMs and 30.3 % used more than two types of CAMs for their health status. Of the patients who used CAM, herbal therapies were used most often (43.5 %), followed by honey (35.6 %), diet (22.8 %), and exorcism in Islam (16.9 %). The herbal therapies mentioned most often were Nigella sativa L. (18.7 %), followed by Salvia officinalis L. (16.9 %), and Pimpinella anisum L. (10.5 %). CONCLUSIONS In conclusion, the prevalence of CAM is relatively high in the selected population. Most patients used biological therapies such as herbal remedies, thus highlighting a greater need for patient education regarding CAM therapies and possible herb-drug interactions. Health care providers must be aware of the potential benefits and risks related to CAM use. There is a need for more clinical research pertaining to CAM to reach stronger evidence regarding potential benefits and risks related to CAM use.
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Affiliation(s)
- Sa’ed H. Zyoud
- Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- WHO Collaborating Centre for Drug Information, National Poison Centre, Universiti Sains Malaysia (USM), Penang, 11800 Malaysia
| | - Samah W. Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Waleed M Sweileh
- Department of Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ghada H. Tabeeb
- PharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Nora A. Ayaseh
- PharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Mayas N. Sawafta
- PharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Razan L. Khdeir
- PharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Diana O. Mezyed
- PharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Dala N. Daraghmeh
- PharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Rahmat Awang
- WHO Collaborating Centre for Drug Information, National Poison Centre, Universiti Sains Malaysia (USM), Penang, 11800 Malaysia
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