Profiling patient attitudes to phosphate binding medication: A route to personalising treatment and adherence support

Chater, Angel M.; Parham, Rhian; Riley, Stephen; Hutchison, Alastair J.; Horne, Rob

doi:10.1080/08870446.2014.942663

Cited by 22 publications

(31 citation statements)

References 33 publications

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“…44,48,49 Dietary intake patterns in our own unit have confirmed this strong trend. Phosphate binder medication, traditionally prescribed to be taken "with meals" now should be directed to times of higher food intake.…”

Section: Accept the Fact That Patients Often Do Not Eat Three Traditisupporting

confidence: 61%

“…It has also been estimated that adherence to binder use as prescribed may be less than 50%. [44][45][46][47][48][49] Recent research has shown that phosphorus absorption varies among foods. Current nutrition advice in phosphate control is moving toward a greater understanding by both patients and health care teams on newly understood mechanisms of phosphate content and absorption.…”

Section: Phosphorus Binders and Food Absorption Differencesmentioning

confidence: 99%

“…49 Older patients have been consistently observed to be more willing to adhere to dietary parameters. 21,44 Reading level and health literacy have also been studied and shown to be factors in dietary adherence. 52 Aligning educational resources to cultural beliefs may also improve adherence by providing more practical applications and examples that are personalized.…”

mentioning

confidence: 99%

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Strategies to promote adherence to nutritional advice in patients with chronic kidney disease: a narrative review and commentary

Beto¹,

Schury²,

Bansal³

2016

IJNRD

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Chronic kidney disease (CKD) requires extensive changes to food and lifestyle. Poor adherence to diet, medications, and treatments has been estimated to vary between 20% and 70%, which in turn can contribute to increased mortality and morbidity. Delivering effective nutritional advice in patients with CKD coordinates multiple diet components including calories, protein, sodium, potassium, calcium, phosphorus, and fluid. Dietary intake studies have shown difficulty in adhering to the scope and complexity of the CKD diet parameters. No single educational or clinical strategy has been shown to be consistently effective across CKD populations. Highest adherence has been observed when both diet and education efforts are individualized to each patient and adapted over time to changing lifestyle and CKD variables. This narrative review and commentary summarizes nutrition education literature and published strategies for providing nutritional advice in CKD. A cohort of practical and effective strategies for increasing dietary adherence to nutritional advice are provided that include communicating with "talking control" principles, integrating patient-owned technology, acknowledging the typical food pattern may be snacking rather than formal meals, focusing on a single goal rather than multiple goals, creating active learning and coping strategies (frozen sandwiches, visual hands-on activities, planting herb gardens), and involving the total patient food environment.

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Section: Accept the Fact That Patients Often Do Not Eat Three Traditisupporting

confidence: 61%

Section: Phosphorus Binders and Food Absorption Differencesmentioning

confidence: 99%

mentioning

confidence: 99%

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Strategies to promote adherence to nutritional advice in patients with chronic kidney disease: a narrative review and commentary

Beto¹,

Schury²,

Bansal³

2016

IJNRD

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“…Reasons for PB non‐adherence may include overall treatment non‐adherence, lower socioeconomic status, or lack of understanding of likely benefits of lower SPhos . Another possible reason is a high pill burden.…”

Section: Discussionmentioning

confidence: 99%

“…Reasons for PB non-adherence may include overall treatment non-adherence, lower socioeconomic status, or lack of understanding of likely benefits of lower SPhos. [24][25][26] Another possible reason is a high pill burden. Consistent with other observational studies, we show a trend toward an association (unadjusted P = 0.01, adjusted P = 0.15) between higher PB pill burden and patient-reported PB non-adherence.…”

Section: Hemodialysis International 2015; ••:••-••mentioning

confidence: 99%

Phosphate binder pill burden, patient‐reported non‐adherence, and mineral bone disorder markers: Findings from the DOPPS

Fissell

Karaboyas

Bieber

et al. 2015

Hemodialysis International

108

107

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Background Due to multiple comorbidities, hemodialysis (HD) patients are prescribed many oral medications, including phosphate binders (PBs), often resulting in a high “pill burden”. Methods Using data from the international Dialysis Outcomes and Practice Patterns Study (DOPPS), we assessed associations between PB pill burden, patient-reported PB non-adherence, and levels of serum phosphorus (SPhos) and parathyroid hormone (PTH), using standard regression analyses. The study included data collected from 5,262 HD patients from dialysis units participating in the DOPPS in 12 countries. Results PB prescription ranged from a mean of 7.4 pills/day in the United States (US) to 3.9 pills/day in France. About half of the patients were prescribed at least 6 PB pills/day, and 13% were prescribed at least 12 PB pills/day. Overall, the proportion of patients who reported skipping PBs at least once in the past month was 45% overall, ranging from 33% in Belgium to 57% in the US. There was a trend toward greater PB non-adherence and a higher number of prescribed PB pills/day. Non-adherence to PB prescription was associated with high SPhos (>5.5 mg/dL) and PTH (> 600 pg/mL). Conclusions Adherence to PB is a challenge for many hemodialysis patients and may be related to the number of PB pills prescribed. Prescription of a simplified PB regimen could improve patient adherence and perhaps improve SPhos and PTH levels.

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Medication and Treatment Beliefs as Determinants of Treatment Engagement

Horne¹

2020

The Wiley Handbook of Healthcare Treatment Engagement

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Profiling patient attitudes to phosphate binding medication: A route to personalising treatment and adherence support

Cited by 22 publications

References 33 publications

Strategies to promote adherence to nutritional advice in patients with chronic kidney disease: a narrative review and commentary

Strategies to promote adherence to nutritional advice in patients with chronic kidney disease: a narrative review and commentary

Phosphate binder pill burden, patient‐reported non‐adherence, and mineral bone disorder markers: Findings from the DOPPS

Medication and Treatment Beliefs as Determinants of Treatment Engagement

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