Overcoming obstacles for adherence to phosphate binding medication in dialysis patients: a qualitative study

Abstract

Objective: The aim of this study was to explore obstacles to adherence to phosphate binding medication and to describe the measures taken by dialysis patients to overcome these obstacles.

Setting: A Swedish renal unit.

Method: Ten patients undergoing dialysis were interviewed. The interviews were semi-structured and were analysed according to qualitative content analysis.

Main outcome measure: Statements about barriers and the ways to overcome these.

Results: Non user-friendly drug compound, feeling of discomfort, forgetfulness, polypharmacy and patient ignorance were identified as obstacles to adherence to phosphate binding medication. Measures taken by the patients to handle obstacles were identified as using a dispensing aid, consuming extra water and exercising routines.

Conclusion: Dialysis patients identify obstacles that impede patient adherence to prescribed phosphate binding medication. The patients overcame most obstacles by self-management but not always in concordance with treatment requirements. Our findings imply that the ways the patient conquer each barrier need to be considered when strategies for self-management are promoted.