Phosphate Binder’s Adherence and Knowledge among Hemodialysis Patients in Karbala Center, Cross-Sectional Study
Reyadh Jassem, Iman Sabeeh Hasan, Liqaa M. Al-Sharifi,
Firas Ghafil Abba, Iman O. Al-shammary
Among patients with end stage renal disease (ESRD), the Non-adherence to phosphate binder medications represents a big contributor for hyperphosphatemia management failure. Hence, it makes the patient prone for high risk of cardiovascular morbidity and all-cause mortality as a consequence of hyperphosphatemia. Thus, we tend in this study to investigate whether there is an association between adherence, knowledge, serum phosphate, and any of patient demographic characteristics affecting phosphate binder adherence. This study is a cross sectional, descriptive, single arm study for the purpose of evaluating the patient adherence and knowledge toward phosphate binder medications in hemodialysis patients with hyperphosphatemia. This study was conducted at the dialysis Centers in Al_Imam Al Hussein Teaching Hospital. All participating patients were asked to answer two questionnaires [Patient Knowledge questionnaire and Morisky Medication Adherence Scale]. 204 patients participate in the study where the percentage of residence from inside of Karbala was 97.5 %. The study shows the major cause of chronic kidney disease in most patient was hypertension with percentage (N=70, 34.3%), followed by diabetes mellitus by 15.7%. About knowledge, 58% answered accurately about phosphate binders’ indication. In regard to the question, ‘’When should you take your phosphate binder?’ 37.2% responded true and around 95% give inappropriate answer about the question’ ’What should you do if you have forgotten to take your phosphate binder? ’’58% of patients didn't know if there's side effect for phosphate binders or not while 21.9% showed Nausea, vomiting, headache and constipation. In this study, about half of the participants show intermediate adherence 52.4% The phosphate level was significantly low in high adherence group. Phosphate binders widely used among hemodialysis patients. The phosphate level was affected by the extent of adherence to the phosphate binders where high control level of phosphate was seen in high adherence population. About patients' knowledge towards phosphate binders, most of them reported the right answer toward indication of phosphate binder, while those dealing with dosing, their knowledge was insufficient.
Keywords: CKD, Morsky Score, ESRD, Phosphate Binders, Hemodialysis
