ISSN 2394-7330 International Journal of Novel Research in Healthcare and Nursing Vol. 6, Issue 1, pp: (72-84), Month: January - April 2019, Available at: www.noveltyjournals.com Page | 72 Novelty Journals Nursing instructions Improve Medication Adherence among Patients undergoing Hemodialysis Dalia Salah El-Deen 1 , Amel Saied Mahmoud 2* 1 Assistant Professor of Medical Surgical Nursing, Faculty of Nursing, Cairo University, Egypt 2 Lecturer of Medical surgical Nursing, Faculty of Nursing, Cairo University, Egypt *Corresponding Author's Email: amalsaied19@yahoo.com cartsbAt: End-stage kidney disease has become a major concern worldwide the total number of these patients receiving hemodialysis has been grown globally. Medication nonadherence is highly prevalent in such patients with an average prevalence rate of 52.5%. Aim: The aim of the current study was to evaluate the effect of nursing instructions on knowledge, attitude and medication adherence among patients undergoing hemodialysis. Methodology: A quazi experimental nonequivalent control group design was utilized. A convenient sample of 60 adult patients on hemodialysis, randomly divided into study and control groups (30 patients each).The study conducted in the hemodialysis department at one of the University hospital in Cairo, Egypt. Data were collected through; Demographic and Medical Data Sheet, Knowledge Assessment Sheet, 13-Item Semantic Differential Scale, and 8-Item Morisky Medication Adherence Scale. Results: There were statistically significant improvement of knowledge; attitude and adherence regarding medication regimen in the study group after implementation of the nursing instructions in comparison to the control group. Conclusion: nursing instructions improve patients’ knowledge, attitude and adherence to medications. Undoubtedly, this is an important factor in preserving and improving patients’ health among patients undergoing hemodialysis. Recommendation: It is suggested to apply these nursing instructions for patients undergoing hemodialysis in the early course of the treatment. Keywords: Nursing instructions, medication adherence, hemodialysis. I. INTRODUCTION Chronic kidney disease (CKD) is a modern day global epidemic and is currently recognized as a public health issue [1,2]. The burden of CKD continues to increase, affecting 10–15% of individuals and health systems in low‐, middle‐, and high‐ income countries with significant mortality and morbidity [3]. Chronic kidney disease, as it continues from early stage (stage 1) to late stage (stage 5) which is called End-stage Kidney disease (ESKD), requires renal replacement therapy [4,5]. End-stage kidney disease has become a major concern worldwide as the total number of ESKD patients receiving hemodialysis has been grown globally and the cost is increasing substantially [6,7]. In USA, there are more than (65%) of patients with chronic kidney disease under hemodialysis treatment, more than (28%) have transplanted kidney, and more than (7%) are under peritoneal dialysis treatment[8]. Moreover, an estimated 2.6 million people worldwide received dialysis treatment for ESKD in 2010, and a two-fold increase is expected by 2030 [9].