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Interventional study to improve adherence to phosphate binder treatment in dialysis patients
BACKGROUND: Adherence to phosphate binder treatment is important to prevent high serum phosphate level in chronic dialysis patients. We therefore wanted to investigate patient knowledge, beliefs about and adherence to phosphate binders among these patients and assess whether one-to-one pharmacist-le...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525353/ https://www.ncbi.nlm.nih.gov/pubmed/31101020 http://dx.doi.org/10.1186/s12882-019-1334-x |
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author | Hjemås, Bodil Jahren Bøvre, Katrine Mathiesen, Liv Lindstrøm, Jonas Christoffer Bjerknes, Kathrin |
author_facet | Hjemås, Bodil Jahren Bøvre, Katrine Mathiesen, Liv Lindstrøm, Jonas Christoffer Bjerknes, Kathrin |
author_sort | Hjemås, Bodil Jahren |
collection | PubMed |
description | BACKGROUND: Adherence to phosphate binder treatment is important to prevent high serum phosphate level in chronic dialysis patients. We therefore wanted to investigate patient knowledge, beliefs about and adherence to phosphate binders among these patients and assess whether one-to-one pharmacist-led education and counselling enhance adherence and lead to changes in serum phosphate levels. METHODS: A descriptive, interventional, single arm, pre-post study was performed at a hospital in Norway, including chronic dialysis patients aged 18 years or more using phosphate binders. The primary end-point was change in the proportion of patients with serum phosphate below 1.80 mmol/L and the secondary end-points included change in the patient’s knowledge, beliefs and adherence after the intervention measured by completion of questionnaires ‘Patient Knowledge’, Medication Adherence Report Scale (MARS− 5) and Beliefs about Medicines Questionnaire (BMQ). Data was collected both prior to and after one-to-one pharmacist-led education and counselling about their phosphate binders. Other medicines used by the patient was also registered. RESULTS: A total of 69 patients were enrolled in the study. After intervention, the probability of serum phosphate being below the target threshold 1.80 mmol/L (5.58 mg/dL) increased, although no significant change in mean serum phosphate levels was seen. On the other hand, the knowledge regarding phosphate binder treatment and the patients’ beliefs about the necessity of the treatment increased, while the concerns decreased (BMQ). This effect did not lead to increase in self-reported adherence measured by MARS-5. However the scores were high before the intervention. CONCLUSIONS: Short term one-to-one individualized pharmacist-led education and counselling about phosphate binders increased the probability of serum phosphate concentrations being below the target threshold level 1.80 mmol/L (5.58 mg/dL), although not statistically significant. However, it did not decrease the mean serum phosphate level or increase the patients’ self-reported adherence. The patients increased their knowledge about the phosphate binder and their understanding of adherence, and were less concerned about the side effects of the medication. TRIAL REGISTRATION: ISRCTN52852596, registered 11 April 2019. The trial was registered retrospectively. |
format | Online Article Text |
id | pubmed-6525353 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-65253532019-05-24 Interventional study to improve adherence to phosphate binder treatment in dialysis patients Hjemås, Bodil Jahren Bøvre, Katrine Mathiesen, Liv Lindstrøm, Jonas Christoffer Bjerknes, Kathrin BMC Nephrol Research Article BACKGROUND: Adherence to phosphate binder treatment is important to prevent high serum phosphate level in chronic dialysis patients. We therefore wanted to investigate patient knowledge, beliefs about and adherence to phosphate binders among these patients and assess whether one-to-one pharmacist-led education and counselling enhance adherence and lead to changes in serum phosphate levels. METHODS: A descriptive, interventional, single arm, pre-post study was performed at a hospital in Norway, including chronic dialysis patients aged 18 years or more using phosphate binders. The primary end-point was change in the proportion of patients with serum phosphate below 1.80 mmol/L and the secondary end-points included change in the patient’s knowledge, beliefs and adherence after the intervention measured by completion of questionnaires ‘Patient Knowledge’, Medication Adherence Report Scale (MARS− 5) and Beliefs about Medicines Questionnaire (BMQ). Data was collected both prior to and after one-to-one pharmacist-led education and counselling about their phosphate binders. Other medicines used by the patient was also registered. RESULTS: A total of 69 patients were enrolled in the study. After intervention, the probability of serum phosphate being below the target threshold 1.80 mmol/L (5.58 mg/dL) increased, although no significant change in mean serum phosphate levels was seen. On the other hand, the knowledge regarding phosphate binder treatment and the patients’ beliefs about the necessity of the treatment increased, while the concerns decreased (BMQ). This effect did not lead to increase in self-reported adherence measured by MARS-5. However the scores were high before the intervention. CONCLUSIONS: Short term one-to-one individualized pharmacist-led education and counselling about phosphate binders increased the probability of serum phosphate concentrations being below the target threshold level 1.80 mmol/L (5.58 mg/dL), although not statistically significant. However, it did not decrease the mean serum phosphate level or increase the patients’ self-reported adherence. The patients increased their knowledge about the phosphate binder and their understanding of adherence, and were less concerned about the side effects of the medication. TRIAL REGISTRATION: ISRCTN52852596, registered 11 April 2019. The trial was registered retrospectively. BioMed Central 2019-05-17 /pmc/articles/PMC6525353/ /pubmed/31101020 http://dx.doi.org/10.1186/s12882-019-1334-x Text en © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Hjemås, Bodil Jahren Bøvre, Katrine Mathiesen, Liv Lindstrøm, Jonas Christoffer Bjerknes, Kathrin Interventional study to improve adherence to phosphate binder treatment in dialysis patients |
title | Interventional study to improve adherence to phosphate binder treatment in dialysis patients |
title_full | Interventional study to improve adherence to phosphate binder treatment in dialysis patients |
title_fullStr | Interventional study to improve adherence to phosphate binder treatment in dialysis patients |
title_full_unstemmed | Interventional study to improve adherence to phosphate binder treatment in dialysis patients |
title_short | Interventional study to improve adherence to phosphate binder treatment in dialysis patients |
title_sort | interventional study to improve adherence to phosphate binder treatment in dialysis patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525353/ https://www.ncbi.nlm.nih.gov/pubmed/31101020 http://dx.doi.org/10.1186/s12882-019-1334-x |
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