Comparison of the effect of educational and self‐management interventions on adherence to treatment in hemodialysis patients: A systematic review and meta‐analysis of randomized controlled trials

Background Adherence to fluid intake, diet, and drug management is very important in hemodialysis patients. Educational and self‐management interventions are frequently used to improve adherence to treatment in hemodialysis patients. Objectives To synthesize a comparison of the effect of educational and self‐management interventions on adherence to treatment in hemodialysis patients in randomized controlled trials. Methods Systematic searches were conducted using 11 multidisciplinary databases in June 2020. The PRISMA checklist was used. The subgroup analysis was used to compare the effect of educational and self‐management interventions on adherence to fluid intake, diet, and drug management. Results In the included studies, educational interventions were performed ranging from 15 to 60 minutes, in 1‐72 sessions. Self‐management interventions were performed ranging from 10 to 120 minutes, in 1‐84 sessions. The overall effect of educational interventions was small on adherence to fluid intake (P = .019, Hedges’ g = −0.39), diet in serum phosphorus level (P = .001, Hedges’ g = −0.35), drug management (P = .002, Hedges’ g = −0.44), and not significant on adherence to diet in serum potassium level (P = .181). The overall effect of self‐management interventions was small on adherence to fluid intake (P = .001, Hedges’ g = −0.19) and diet in serum phosphorus level (P