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Travel Distance and Compliance to Haemodialysis in an Urban Setting in Sarawak

Conference

Introduction:

Haemodialysis is the life line for many patients with chronic renal failure. However, compliance to haemodialysis is a major concern in the rural setting. Noncompliance can be as high as 9%. We reviewed a cohort of patients requiring haemodialysis in Sarawak General Hospital (SGH), looking in particular their attendance rate and the distance from home to SGH.

Method:

Between 16 July to 16 August 2012, 100 haemodialysis patients in SGH were identified. Demographics, current home address and the number of missed sessions for the one month period were collected. The nephrology team was blinded to the data collection. Unidirection distances of the hospital from respective patients’ addresses were calculated using Google Earth. Statistical analyses were done using SPSS ver. 19.

Results:

Of the 100 patients, 40 were Dayaks, followed by 29 Chinese and Malay patients each and 2 Indians. The mean age was 54.2 year-old, ranging from 19 – 89 year-old. There were 130 events of missed dialysis from a total of 1200, giving a rate of 10.8%.

Three patients live outside the locality of the hospital (> 15 miles/24.1km away). Of those within the locality (97); the majority (77) live within 10km. Patients living outside the locality of the hospital are significantly more likely to miss their dialysis session(s) compared to those within (P < 0.001).

Other factors such as age (P = 0.339) and gender (P = 0.655) were not significant.

Discussion:

Our noncompliance rate is comparable to previous Malaysian studies. SGH is located in the centre of Kuching City with good road access. Despite this, some patients still face travel issues slightly different from other states in Malaysia. A 5km travel via boat or village lane is more challenging than a 5 km travel on tar road. Further studies looking at this issue for rural haemodialysis patients would enable better planning for future dialysis centres.

Conclusion:

Travel distance is a significant factor for noncompliance to haemodialysis in Sarawak General Hospital, Kuching.

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