Abstract: PO1455
Patient and Clinician Preferences for Hyperkalemia Treatment: A Qualitative Study
Session Information
- Fluid, Electrolyte, and Acid-Base Disorders: Clinical - 1
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid, Electrolyte, and Acid-Base Disorders
- 902 Fluid, Electrolyte, and Acid-Base Disorders: Clinical
Authors
- Israni, Rubeen K., AstraZeneca, Wilmington, Delaware, United States
- Brooks, Anne B., Evidera, London, United Kingdom
- Tervonen, Tommi, Evidera, London, United Kingdom
- Huang, Joanna C., AstraZeneca, Wilmington, Delaware, United States
- Szerlip, Harold M., Baylor University Medical Center, Dallas, Texas, United States
Background
Treatment options for chronic hyperkalemia include the potassium binders Kayexalate®, Veltassa®, and since 2018, Lokelma®. In a qualitative research study, we explored which treatment characteristics are important to patients with hyperkalemia and treating clinicians.
Methods
Adult patients in the US who had received treatment for chronic hyperkalemia in the past 12 months and US clinicians who had treated ≥10 patients with chronic hyperkalemia with potassium binders in the last 3 months participated in focus group discussions consisting of concept elicitation and a ranking exercise, guided by a semi-structured discussion guide, with potential attributes identified through review of product labels.
Results
Twenty-five patients (52.4 ± 14.8 years; 56% male; 32% on dialysis; 20% kidney transplant recipients) and eight clinicians (n=4 nephrologists, n=2 cardiologists, n=2 hospitalists) participated. For patients, the most commonly reported medication side effect was diarrhea (64%), followed by abdominal pain and cramping (56%), nausea and/or vomiting, bloating/flatulence, and cramping in hands and legs (all 36%). The most disliked treatment characteristic was the medication’s taste/texture; 58% of patients ranked it among three most important treatment characteristics. Although most patients reported gastrointestinal-related side effects, 54% did not rank diarrhea and 46% did not rank abdominal cramping in the top three characteristics. For clinicians, the most commonly encountered medication side effect was diarrhea (50%), followed by abdominal cramping (25%) and constipation (25%), and the most commonly considered treatment characteristic when prescribing a binder was taste/texture (50%), followed by time before/after taking medications (38%), time to onset (38%) and adherence (38%). Sustained efficacy followed by time to onset were ranked by 88% of clinicians as the two most important characteristics. Medication preparation, medication storage, and constipation were ranked low by both patients and clinicians.
Conclusion
Different potassium binder characteristics are most important to patients (taste/texture and abdominal cramping) and clinicians (sustained efficacy and time to onset). Clinicians should therefore take patient preference into consideration when prescribing a potassium binder.
Funding
- Commercial Support – AstraZeneca