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Why consider illness perception in renal disease patients?

CARE’s approach to addressing non-adherence
Tessa van Leeuwen

Digital Lead and Facilitator

19 January 2022

It is not surprising that with the rigid medical regime required in end-stage renal disease (ESRD), patients can struggle to adhere. Adherence to treatment is key to establish effective management of ESRD since non-adherence to dialysis can have severe clinical outcomes and even lead to premature death (Kimmel et all, 1995). In a recent chapter on adherence and illness perception in patients with renal disease, Dr Joseph Chilcot, Professor John Weinman and Dr Ken Farrington (2020) argue that we need more robust psychosocial interventions to support patients’ adherence

Many factors, including mood, self-efficacy, social support, illness and treatment perceptions and mood, influence intentional and unintentional non-adherence and can be targeted in specifically designed interventions. Illness perceptions describe the ways in which patients make sense of their medical condition and these are made up of five interlinked dimensions: the way we view our symptoms, our beliefs about the cause of the illness, the duration of the illness, the consequences of the illness, and the amount of control we think we have over the illness or ability to cure it. In addition to having direct effects on adherence, illness perceptions will also affect a patient’s view of their treatment, particularly how necessary they perceive treatment to be (Horne et al, 1999).

Looking at illness perception and the initial research into the capacity of psychosocial interventions to alter unhelpful illness and treatment beliefs, there is now a need to harness this evidence to develop and evaluate tailored interventions to support patient adherence in ESRD.


Chilcot J, Weinman J & Farrington K (2020) Adherence and illness perceptions in patients with CKD and ESRD. In D.Cukor, S. Cohen & P. Kimmel (Eds) Psychosocial aspects of chronic kidney disease : exploring the impact of CKD, dialysis and transplantation on patients. NY: Elsevier/Academic Press.

Horne R & Weinman J (1999) Patients’ beliefs about prescribed medicines and their role in adherence treatment in chronic physical illness. J Psychosom Res, 47, 6, 555-567

Kimmel PL, Peterson RA, Wehs KL et al (1995) Behavioral compliance with dialysis prescription in hemodialysis. J Am Soc Nephrol, 5, 1826-1834.

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