More Intensive Education on Diet, Binders Needed
Educated patients achieved better phosphate binder adherence.
CHICAGO—An intervention aimed at increasing patient adherence to a low phosphate diet and phosphate binder therapy appears helpful, researchers reported at the American Society of Nephrology's 2016 Kidney Week meeting.
Eunsoo Lim, MD, and colleagues of Ajou University Hospital, Suwon in Kyeong-gi, Korea, randomly assigned 48 hyperphosphatemia patients to an education group and 22 to a control group in a 3-month trial. Pharmacists informed the education group on how and when to take their phosphate binder medication, then tested their knowledge via questionnaire. Dietitians also provided nutritional counseling on avoiding high phosphorus foods.
Similar proportions of educated and control patients attained a calcium-phosphorus product lower than 55: 75% vs 72.7% after 1 month and 70.8% and 68.2% after 2 to 3 months. Drug compliance, assessed by Morisky Medication Adherence Scales-4, also was similar between groups over the short and long term.
Educated patients achieved better phosphate binder adherence (22.9% vs 3.5%). Dietary advice did not affect dietary phosphate intake: -1.18 for education vs -0.88 mg/kg for control. But it did comparatively reduce the dietary phosphate to protein ratio: -0.64 vs 0.65.
In this study, education did not reduce the calcium phosphate product. “However, patient's knowledge on proper timing of phosphate binder intake was enhanced and dietary phosphate to protein ratio was reduced in spite of statistical insignificance,” Dr Lim and colleagues explained. “These findings raise the importance of continuous and individualized educational efforts to lower phosphate intake and improve phosphate binder compliance.”
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- Villacorta J, Tato AM, and Fernandez Juarez G. Incidence of Hyperphosphatemia and Hypocalcemia Secondary to Phosphate Enema Administration. Presented at: Kidney Week 2016. November 15-20, 2016. Chicago. Abstract TH-PO763.