Associations with wellbeing and medication adherence in young adults receiving renal replacement therapy: data from the SPEAK Study

BACKGROUND AND OBJECTIVES: Young adults receiving kidney replacement therapy have impaired quality of life and may exhibit low medication adherence. We tested the hypothesis that wellbeing and medication adherence are associated with psychosocial factors.

DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: We conducted a cross-sectional online survey for young adults on KRT. Additional clinical information was obtained from the United Kingdom Renal Registry. We compared outcomes by treatment modality using age and sex adjusted regression models, having applied survey weights to account for response bias by gender, ethnicity and socio-economic status. We used multivariable linear regression to examine psychosocial associations with scores on the Warwick-Edinburgh Mental Wellbeing Scale and the 8-item Morisky Medication Adherence Scale.

RESULTS: We recruited 976 young adults and 64% responded to the survey - 417 (71%) with transplants and 173 (29%) on dialysis. Wellbeing was positively associated with extraversion, openness, independence, and social support, and negatively associated with neuroticism, negative body image, stigma, psychological morbidity, and dialysis. Higher medication adherence was associated with living with parents, conscientiousness, physician access satisfaction, patient activation, age, and male sex, and lower adherence with comorbidity, dialysis, education, ethnicity and psychological morbidity.

CONCLUSIONS: Wellbeing and medication adherence were both associated with psychological morbidity in young adults. Dialysis treatment is associated with poorer wellbeing and medication adherence.