Unintentional non-adherence to phosphate binders

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The aim of this study was to determine patient specific perceptual and practical barriers to adherence to phosphate binders. The second stage aimed to determine the effectiveness of an adherence enhancing strategy trialled by patients.


A prospective, cross sectional study of patients attending a dialysis unit at a specialist centre, in central London, over a 6-month period (April-September 2013). Through patient questionnaires, an initial assessment was performed of specific barriers to adherence for each individual. Following this, an unintentional barrier to adherence was targeted: transportation of medication when away from home. Small pill pots were trialled by patients as an adherence enhancing strategy.


13% patients admitted to not being adherent to their phosphate binders on a daily basis. The most common reasons reported were forgetting and difficulty in transportation of the medications when away from home. 94% patients claimed benefits to their adherence to phosphate binders as a result of the pill pot intervention.


Non-adherence to phosphate binders continues to be an issue. With 94% patients claiming improved adherence with a smaller transportable pill pot, a potential patient-centred intervention has been explored to overcome an unintentional barrier.

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