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Biomedical subjects

P Sacksteder

Publications and source records attributed to P Sacksteder.

6 recordsLinked to original sources
PubMed1997

Differences in older versus younger hemodialysis patients' noncompliance with oral medications.

Hemodialysis patients' compliance with their therapeutic regimens, including dietary and fluid restrictions, dialysis treatments and medications, is generally suboptimal. Recently, the mean age of the dialysis population has increased. Since impaired cognitive function, which sometimes accompanies aging, interferes with the ability to comprehend instructions, elderly dialysis patients might be at greater risk for noncompliance than are their younger counterparts. In this project, 135 hemodialysis patients (68 patients > 65 years of age and 67 patients < or = 65 years) were studied. Rates of noncompliance with oral antihypertensives and phosphate binders, as tracked by a medication event monitoring system (MEMS), are reported here. More than 42% of older patients (> 65) and 47% of younger patients (< or = 65) were repeated noncompliers with antihypertensives, missing at least 20% of the prescribed doses. Similarly, 65% of older patients and 80% of younger patients exhibited repeated noncompliance with phosphate binders. Almost 30% of older patients and more than 32% of younger patients missed their antihypertensives completely on 20% or more of the prescribed days. Only 18% of the older subjects, but 33% of younger patients missed taking their phosphate binders for 20 or more percent of the prescribed days. Rates of noncompliance were found to differ between the two populations of patients in that younger patients made significantly more dosing errors with their antihypertensives and missed taking their phosphate binders on more days than did their older counterparts.

Administration, Oral↗
PubMed1996

Differences between employed and nonemployed dialysis patients.

Three hundred fifty-nine chronic dialysis patients (85 employed and 274 nonemployed) were surveyed to identify/verify those characteristics which differentiate between employed versus nonemployed status. Education emerged as a significant correlate of employment, as noted by previous investigators, whereas, unlike previous research, neither mode of dialysis, length of time on dialysis, number of comorbid conditions, nor cause of renal failure (eg, diabetes) were associated with employment status. Measures of functional status (MOS SF-20 and Karnofsky) were positively associated with employment. Furthermore, patients' perceptions that their health limited the type and amount of work that they could do were negatively associated with employment. In addition, using a series of de novo items, we found subjects' beliefs about dialysis patients' ability to work to be a "self-fulfilling prophecy" with regard to employment status. That is, patients who themselves believed that dialysis patients should work and had this notion reinforced by significant others were more likely to be employed. Interestingly, 21 percent of unemployed patients reported that they were both able to work and wanted to return to work. Because it is consistently reported that only a small percentage of dialysis patients are employed, targeting the patients who are both willing and able to work for vocational rehabilitation might significantly increase the numbers of employed dialysis patients.

Adolescent↗