Adherence to Dialysis Therapy and Associated Factors Among Insured Patients with End Stage Renal Disease Attending Dialysis Centers in Northern Zone of Tanzania

The aim of the study was to determine adherence to dialysis therapy and associated factors among insured patients with end stage renal disease attending dialysis centers in the Northern zone of Tanzania. It was a hospital based cross-sectional study using both qualitative and quantitative methods of data collection via interviews. Categorical variables were summarized by frequency and percentage while continuous variables were summarized by mean and standard deviation the factors associated with adherence to dialysis therapy were estimated by multivariable logistic regression and qualitative data were analyzed using thematic analysis, findings with p-value of less than or equal to 0.05 were considered statistically significant. The study revealed that adherence to dialysis therapy was 55% and significant factors associated with adherence were age above 60 years, higher education level, unemployment, more than five (5) years in dialysis, transport unavailability, and high frequency of receiving health information. Thematic analysis revealed inaccessibility of dialysis services in terms of travel distance, poor roads and financial constraints were factors for non-adherence. While social support, awareness of disease and desire to prolong life were factors for good adherence. Collectively the results seem to indicate that more than half of insured patients with ESRD had good adherence status. Findings from this study recommend the need of strong social support relationship between patients, family members and HCWs in dialysis units. In addition, health system should Prioritize transport access, road infrastructure, proximity to dialysis centers and ongoing patient education and counseling.