Treatments burden in adults with end stage renal disease receiving haemodialysis impact on medication adherence and health related quality of life.

Abstract

Background: Haemodialysis imposes substantial treatment burden, affecting medication adherence and health-related quality of life (HRQoL). This study assessed treatment burden and its associations with these outcomes in adults receiving haemodialysis. Aim: To assess treatment burden in adults with end-stage renal disease (ESRD) receiving haemodialysis and examine its associations with medication adherence and HRQoL. Materials and Methods: A systematic search of PubMed, Embase and Scopus was conducted for publications from 2000 to 2026. After deduplication of 290 records, manual screening yielded 37 eligible studies — restricted to systematic reviews, meta-analyses, clinical trials, and Mendelian randomisation analyses involving adults (≥18 years). Results: Treatment burden in haemodialysis patients is multidimensional, encompassing high pill burden, time demands and significant psychological distress. Non-adherence rates reached up to 50%, driven by regimen complexity, depression, and caregiver strain. Physical HRQoL was more severely impaired than mental HRQoL, with fatigue and musculoskeletal symptoms as primary drivers. Longer dialysis vintage correlated with progressive symptom worsening Conclusions: Treatment burden in ESRD patients undergoing haemodialysis significantly impairs medication adherence and HRQoL, particularly in physical domains. Integrated, patient-centred strategies, including regimen simplification and psychosocial support, are needed.