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Psychiatry and treatment adherence in the renal unit

Published online by Cambridge University Press:  02 January 2018

Janet Butler
Janet Butler*
Affiliation:
Mental Health Group, University of Southampton, Royal South Hants Hospital, Brintons Terrace, Southampton SO14 0YG, UK
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Abstract

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Type
Correspondence
Information
Advances in Psychiatric Treatment , Volume 8 , Issue 2 , March 2002 , pp. 159
Copyright
Copyright © The Royal College of Psychiatrists 2002 

Phipps & Turkington (2001) gave a good overview of the range of psychological difficulties experienced by patients in a renal unit. However, there was one important omission; non-adherence to treatment. Non-adherence to dietary and fluid restrictions by patients receiving dialysis is well recognised and non-adherence to immunosupressant medication following transplantation is now being seen as a major problem. There are several studies showing that at least 20% of all transplant recipients omit some of their immunosuppressants and that non-adherence is a leading cause of premature transplant failure (Reference Schweizer, Rovelli and PalmeriSchweizer et al, 1990). Adherence research in patients with renal and other chronic conditions has indicated the importance of health beliefs (Reference Horne, Myers and MidenceHorne, 1998) and mental state (Reference Bunzel and Laederach-HofmannBunzel & Laederach-Hofmann, 2000) in determining adherence, yet renal staff are likely to have received little, if any, training in the assessment of such areas. Non-adherence to treatment is thus a field in which psychological intervention is likely to make a positive impact and is therefore an area that requires further attention by liaison psychiatrists.

References

Bunzel, B. & Laederach-Hofmann, K. (2000) Solid organ transplantation: are there predictors for posttransplant non-complicance? A literature overview. Transplantation, 70, 711–716.CrossRefGoogle Scholar
Horne, R. (1998) Adherence to medication: a review of existing research. In Adherence to Treatment in Medical Conditions (eds Myers, L. B. & Midence, K.) pp. 285–310. Australia, UK: Harwood Academic Publishers.Google Scholar
Phipps, A. & Turkington, D. (2001) Psychiatry in the renal unit. Advances in Psychiatric Treatment, 7, 426–432.CrossRefGoogle Scholar
Schweizer, R. T., Rovelli, M., Palmeri, D. et al (1990) Non-complicance in organ transplant recipients. Transplantation, 49, 374–377.Google Scholar
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