can addressing family education improve adherence of therapeutic regimen in hemodialysis patients? a randomized controlled clinical trial

b a c k g r o u n d & aim: today, one of the leading causes of pathogenicity and mortality in patients undergoing hemodialysis is their failure to follow the treatment plan. the present research was con- ducted to compare effects of patient-centered  education with family-centered  education on adher- ence with the treatment program. methods & materials: this clinical trial was performed between may and october 2012 in hemo- dialysis ward of imam khomeini and amir-alam hospital in tehran, iran. research samples were60 patients aged 18-65 years old, randomly assigned into two groups: training the patients (30 pa-tients) and training the patients and one of close family member (30 people). using a researcher made questionnaire,  patients’ adherence (diet, pharmaceutical  regimen, and physical activity) was examined by the self-reporting method in three stages (before intervention, 2 and 4 weeks after in- tervention). data were analyzed using independent t-test, chi-square, and fisher tests using spss software version 16. r e s u lt s : prior to intervention, there was no significant difference between the two groups in terms of adherence to diet program (p = 0.200, mean difference 25.8 ± 25.7), to pharmaceutical  regimen (p  =  0.600,  mean  difference  1.96  ±  0.61),  and  physical  activity  (p  =  0.700  mean  difference1.33 ± 0.66). after 2 weeks family-centered education group had significantly more adherence to the diet program (p = 0.001, mean difference 43.1 ± 11.1), pharmaceutical  regimen (p = 0.040, mean difference 2.72 ± 0.5) and physical activity (p = 0.035, mean difference 2.41 ± 0.89), and total ad- herence score (p = 0.030) in comparison with patient-centered education group. after 4 weeks, just the   adherence   to  pharmaceutical   regimen   showedn a significant difference between groups (p < 0.001). c on c l u sio n : the results of this study showed that the family-centered  education is more effective than patient-centered education on patients’ adherence to the therapeutic program particularly phar- maceutical regimen, which suggests, by having family-centered education in hemodialysis patients, the outcome could be improved.