Abstract: SA-PO793
Hyperphosphatemia: Barriers to Treatment Adherence in Dialysis Patients
Session Information
- Health Maintenance, Nutrition, Metabolism - II
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1300 Health Maintenance, Nutrition, and Metabolism
Authors
- Wong, Wei Xiang, University of Arizona, Banner Medical University Tucson, Tucson, Arizona, United States
- Yousman, Wina, University of Arizona, Banner Medical University Tucson, Tucson, Arizona, United States
- Aranas, Jennifer, University of Arizona, Banner Medical University Tucson, Tucson, Arizona, United States
- Bechtold, Lance, University of Arizona, Banner Medical University Tucson, Tucson, Arizona, United States
- Samkari, Kussay, University of Arizona, Banner Medical University Tucson, Tucson, Arizona, United States
- Thajudeen, Bijin, University of Arizona, Banner Medical University Tucson, Tucson, Arizona, United States
- Brosius, Frank C., University of Arizona, Banner Medical University Tucson, Tucson, Arizona, United States
Background
Hyperphosphatemia in end-stage renal disease is associated with increased morbidity and mortality. One important cause of hyperphosphatemia is non-compliance with low phosphate diet and phosphate binders. The primary objective of our study is to evaluate the adherence to prescribed treatment and barriers in accomplishing adherence.
Methods
We collected data from 2 dialysis units in Tucson. A questionnaire was designed to assess dialysis patient’s access to nutritional resources, knowledge of medications as well as dietary restrictions and barriers to access appropriate care. We included patient >18 years old who had phosphorus >5.5mg/dl in the preceding 3 months prior to screening. From the gathered information we identified the top 6 factors responsible for uncontrolled phosphorus and designed strategies to improve patient compliance and accessibility. Data were analyzed using SPSS.
Results
38 patients were included in the final analysis. Mean age of participants was 52.9±16.3 year. Our cohort consisted of 63% male and 53% Hispanic population. 6 most common reasons are represented in figure 1. In 55% of subjects, budget affects the preference of food. 42%, 74% and 39% could not answer low phosphorus drink, snack and meal respectively. 74% suggested that the use of pamphlets for diet education could improve compliance. Reasons for noncompliance: education does not fit food habits, concern for own/family nutrition, fast food.74% not aware of the importance of phosphorus control. 74% not satisfied with doctor’s explanation about phosphorus. 76% complained about phosphorus binders. Most common complaint about binders was size of the pill. Based on the findings, an intervention strategy was designed.
Conclusion
ESRD patients require a multidisciplinary approach to mobilize more local and national resources to achieve good phosphorus control. Diet changes, educational approach, reminder techniques, binder type should be tailored to the individual patient. Patients appreciate doctor’s involvement in the management of phosphorus (it should not be completely left to the dietician.)
Figure 1