Adherence to phosphate binders in hemodialysis patients

prevalence and determinants

Yoleen P M Van Camp, Bernard Vrijens, Ivo L Abraham, Bart Van Rompaey, Monique M. Elseviers

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Phosphate control is a crucial treatment goal in end-stage renal disease, but poor patient adherence to phosphate binder therapy remains a challenge. This study aimed to estimate the extent of phosphate binder adherence in hemodialysis patients and to identify potential determinants.

Methods: Phosphate binder adherence was measured blindly in 135 hemodialysis patients for 2 months using the medication event monitoring system. Patient data, gathered at inclusion through medical records, ad hoc questionnaires and the short form (SF)-36 health survey, included: (1) demographics, (2) perceived side-effects, belief in benefit, self-reported adherence to the therapy, (3) knowledge about phosphate binder therapy, (4) social support, and (5) quality of life (SF-36). Phosphatemia data was collected from charts. ‘Being adherent’ was defined as missing <1 total daily dose/week and ‘being totally adherent’ as missing <1 total daily dose/week, every week.

Results: Mean age of patients was 67 years and 64 % of the sample was male. Over the 2 months, 78 % of the prescribed doses were taken. Every week, about half of patients were adherent. Over the entire 8-week period, 22 % of patients were totally adherent. Mean phosphatemia levels were 0.55 mg/dl lower in adherent than nonadherent patients (4.76 vs. 5.31 mg/dl). Determinants for being totally adherent were living with a partner, higher social support (both were interrelated) and higher physical quality of life. Experiencing intake-related inconvenience negatively affected adherence. The social support and quality of life physical score explained 26 % of the variance in adherence.

Conclusions: Phosphate binder nonadherence remains a major problem. Interventions should aim, at least, to improve social support. With few associated factors found and yet low adherence, an individualized approach seems indicated.

Original languageEnglish (US)
Pages (from-to)673-679
Number of pages7
JournalJournal of Nephrology
Volume27
Issue number6
DOIs
StatePublished - Nov 25 2014

Fingerprint

Renal Dialysis
Phosphates
Social Support
Quality of Life
Therapeutics
Patient Compliance
Health Surveys
Chronic Kidney Failure
Medical Records
Demography

Keywords

  • Adherence
  • Dialysis
  • Electronic measurement
  • Medication
  • Phosphate binders
  • Phosphatemia

ASJC Scopus subject areas

  • Nephrology

Cite this

Adherence to phosphate binders in hemodialysis patients : prevalence and determinants. / Van Camp, Yoleen P M; Vrijens, Bernard; Abraham, Ivo L; Van Rompaey, Bart; Elseviers, Monique M.

In: Journal of Nephrology, Vol. 27, No. 6, 25.11.2014, p. 673-679.

Research output: Contribution to journalArticle

Van Camp, Yoleen P M ; Vrijens, Bernard ; Abraham, Ivo L ; Van Rompaey, Bart ; Elseviers, Monique M. / Adherence to phosphate binders in hemodialysis patients : prevalence and determinants. In: Journal of Nephrology. 2014 ; Vol. 27, No. 6. pp. 673-679.
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abstract = "Background: Phosphate control is a crucial treatment goal in end-stage renal disease, but poor patient adherence to phosphate binder therapy remains a challenge. This study aimed to estimate the extent of phosphate binder adherence in hemodialysis patients and to identify potential determinants.Methods: Phosphate binder adherence was measured blindly in 135 hemodialysis patients for 2 months using the medication event monitoring system. Patient data, gathered at inclusion through medical records, ad hoc questionnaires and the short form (SF)-36 health survey, included: (1) demographics, (2) perceived side-effects, belief in benefit, self-reported adherence to the therapy, (3) knowledge about phosphate binder therapy, (4) social support, and (5) quality of life (SF-36). Phosphatemia data was collected from charts. ‘Being adherent’ was defined as missing <1 total daily dose/week and ‘being totally adherent’ as missing <1 total daily dose/week, every week.Results: Mean age of patients was 67 years and 64 {\%} of the sample was male. Over the 2 months, 78 {\%} of the prescribed doses were taken. Every week, about half of patients were adherent. Over the entire 8-week period, 22 {\%} of patients were totally adherent. Mean phosphatemia levels were 0.55 mg/dl lower in adherent than nonadherent patients (4.76 vs. 5.31 mg/dl). Determinants for being totally adherent were living with a partner, higher social support (both were interrelated) and higher physical quality of life. Experiencing intake-related inconvenience negatively affected adherence. The social support and quality of life physical score explained 26 {\%} of the variance in adherence.Conclusions: Phosphate binder nonadherence remains a major problem. Interventions should aim, at least, to improve social support. With few associated factors found and yet low adherence, an individualized approach seems indicated.",
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