Overcoming obstacles for adherence to phosphate binding medication in dialysis patients: a qualitative study
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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.
KeywordsAdherence Dialysis End-stage kidney disease Medication therapy management Patient compliance Phosphate-binding medication Qualitative research Sweden
We are grateful for the help received from registered nurses Helena Lövén and Marina Levin-Karlsson. As a part of their bachelor education in nursing they prepared the analysis for this study. We would also like to thank the two anonymous reviewers who significantly contributed to improving the manuscript.
This study was financially supported by the County Council of Gävleborg.
Conflict of interest
The authors have no conflict of interest in connection with the content of this study.