The Burden of Dialysis-Related Symptoms and Medication Non-Adherence Among Patients on Peritoneal Dialysis in Oman: A Multi-Center Study
Abstract
Background: Patients on Peritoneal Dialysis (PD) experience substantial dialysis-related symptoms and medication non-adherence that negatively impact clinical outcomes, yet these remain understudied in Oman and other Middle East countries. Objectives: To determine the prevalence of dialysis-related symptoms and assess medication adherence among Omani adult patients on PD. Methods: A descriptive cross-sectional correlational study was conducted among 185 Omani adults receiving PD, recruited using stratified random sampling from government hospitals across Oman. Data were collected using a self-administered questionnaire comprising the researcher-developed Peritoneal Dialysis Symptoms and Life Impact Scale (PD-SLIS; Cronbach’s α = 0.97) and the Arabic version of the Adherence to Refills and Medications Scale (ARMS; Cronbach’s α = 0.71). Data were analyzed using descriptive statistics, chi-square tests, and multiple logistic regression. Results: The participants’ mean age was 51.54 ± 14.92 years, and 50.3% were female. The mean total symptom burden score was 82.56 ± 54.60. The most prevalent symptoms were limitations in general activities (85.9%), mood changes (85.9%), lack of energy (82.7%), and weakness (81%). All the 34 assessed symptoms were reported by ≥47% of the participants. Most participants (66.5%) reported low medication adherence (mean ARMS score = 19.73 ± 5.42). Regression analysis identified age (OR = 1.04, p = 0.02), high school education (OR = 4.68, p < 0.01), and daily number of medications (OR = 0.89, p = 0.04) as significant independent predictors of medication adherence. Conclusions: Omani patients on PD experience a pervasive symptom burden alongside predominantly low medication adherence. Routine symptom screening using the PD-SLIS, polypharmacy reduction strategies, and adherence interventions are recommended as standard components of PD clinical practice in Oman and other settings with similar contexts.