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Chronic diseases often have a relapsing and remitting course with substantial impact on function and Quality of Life(QOL). Poor compliance of the patient also leads to the reduction in the QOL. The aim of the present work is to improve Physical Component Scores (PCS) and Mental Component Scores (MCS) through effective patient counselling and Compliance Behaviour to reduce the relative risk of death and also to compare effectiveness of ESA (Erythropoietin Stimulating Agent) doses in ESRD patients undergoing Haemodialysis. Initially the mean scores are low in QOL and compliance behaviour in elderly patients and were at higher risk of death in the initial stage of study. In certain age groups the PCS and MCS were significantly improved through effective patient counselling and improvement in compliance behaviour.In conclusion it can be said that QOL can be improved and risk of death can be reduced with the effective patient counselling and compliance behaviour, as there is no deviation in haemoglobin levels, use of 4000 units is preferable than 8000 units. Clinical Pharmacy services as part of a multidisciplinary patient care strategy, have led to improvemnet in patient care and QOL.