A preliminary study of PDA-based dietary self-monitoring in hemodialysis patients.
OBJECTIVE
The purpose of this study was to pilot test an intervention to enhance the adherence of study participants to the hemodialysis dietary regimen.


METHODS
A single case study design was used to examine the potential effectiveness of the intervention over a 4-month period of time.


METHODS
A dialysis center in southwestern Pennsylvania.


METHODS
Of the five individuals entered into the study, one was male and four were female, four were black, and one was white. Participants were 63 to 70 years of age, and had been receiving dialysis for a median of 36 months (range, 18 to 84 months).


METHODS
The intervention included counseling to enhance self-efficacy, by a renal dietitian, paired with personal digital assistant-based dietary self-monitoring. Participants met twice per week with interventionists during the first 6 weeks, weekly during the second 6-week period, and biweekly in the final 4-week period.


METHODS
Monthly laboratory data regarding serum albumin, potassium, and phosphorus levels; Kt/V; and data on average monthly interdialytic weight gain were abstracted from the participants' medical records. C-reactive protein level was determined at baseline and at 4 months.


RESULTS
Four of five study participants had an increase in serum albumin level from baseline to their final measurement, and one participant maintained a stable albumin level. Four of five participants also experienced a small increase in serum phosphorus level. Mixed results were obtained with regard to serum potassium and average monthly interdialytic weight gain.


CONCLUSIONS
Because of the small sample and single case study design, caution must be used in drawing firm conclusions from this study. Data suggest that the intervention may result in improved dietary intake and improved serum albumin levels. With increased dietary intake, serum phosphorus levels may increase. Additional research is needed to determine the potential efficacy and cost-effectiveness of this intervention for improving dietary adherence.
Sevick
Mary Ann
MA
Department of Medicine, University of Pittsburgh School of Medicine, and The Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA. mary.sevick@med.va.gov
Piraino
Beth
B
Sereika
Susan
S
Starrett
Terry
T
Bender
Catherine
C
Bernardini
Judith
J
Stark
Susan
S
Burke
Lora E
LE
D000368:Aged; D001519:Behavior; D034201:Computers, Handheld; D004032:Diet; D015930:Diet Records; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010758:Phosphorus / Q000097:blood; D010865:Pilot Projects; D006435:Renal Dialysis; D012648:Self Care; D012709:Serum Albumin / Q000032:analysis
D012709:Serum Albumin; D010758:Phosphorus