IMPACT OF STRUCTURED PATIENT COUNSELING ON HEALTH-RELATED QUALITY OF LIFE AND MEDICATION ADHERENCE AMONG PATIENTS UNDERGOING MAINTENANCE HEMODIALYSIS: A PROSPECTIVE PRE-POST STUDY

Objective: The aim of this study was to evaluate changes in health-related quality of life (HRQoL) and medication adherence after structured patient counseling among adults receiving maintenance hemodialysis. Methods: A prospective longitudinal pre-post study was conducted over 1 year at a tertiary care hospital. The final analysis included 103 adults. HRQoL was assessed with the Kidney Disease Quality of Life Short Form and medication adherence with the 5-item medication adherence report scale (MARS-5; range 5–25). Paired mean changes were summarized with 95% confidence intervals (CIs) and Cohen’s dz. Fourteen pre-post comparisons were treated as exploratory; a Bonferroni threshold of p<0.0036 was used to judge multiplicity-robust findings. Results: Burden of kidney disease increased by 1.94 points (95% CI 1.24–2.64; dz=0.54; p<0.001), emotional well-being by 1.16 (95% CI 0.42–1.90; dz=0.30; p=0.003), mental component summary by 0.84 (95% CI 0.42–1.26; dz=0.39; p<0.001), and MARS-5 by 0.21 (95% CI 0.09–0.33; dz=0.34; p=0.001). Physical functioning decreased by 0.49 points (p=0.025), and role-emotional increased by 1.30 points (p=0.045); these two findings did not meet the Bonferroni threshold. Other domains showed little change. Conclusion: Structured counseling was associated with small-to-moderate improvements in selected kidney disease-related and mental HRQoL outcomes and a small increase in self-reported medication adherence.