Improving haemodialysis patients' understanding of phosphate-binding medication: a pilot study of a psycho-educational intervention designed to change patients' perceptions of the problem and treatment

Abstract

Objectives: To evaluate a psycho-educational intervention aimed to improve understanding of the need for phosphate control, provide a rationale for phosphate-binding medication (PBM) and explain its mode of action.

Design: A controlled intervention study comparing the effect of a self-regulatory theory-based psycho-educational intervention versus standard care control on knowledge of phosphate control and beliefs about PBM.

Method: End-stage renal disease (ESRD) patients were assigned to either an intervention group (N=19) or control group (N=20). Both groups were assessed at baseline, at 1-month post-intervention and at 4-month post-intervention. The intervention group was also assessed immediately post-intervention.

Results: The intervention had an immediate impact post-intervention on all outcome variables examined. It was also successful in improving knowledge, treatment coherence, medication outcome efficacy beliefs, and general understanding of treatment in the intervention group in comparison to the control group, an effect which was sustained through to the second follow-up.

Conclusions: A simple intervention was successful in changing patients' understanding and some beliefs around treatment thought to influence adherence behaviour. Further research is needed to inform the design of a more complex intervention targeting the specific beliefs influencing behaviour in order to facilitate treatment adherence.