title: Dietitian-led education program to improve phosphate control in a single-center hemodialysis population.
abstract: OBJECTIVE
  We sought to analyze the effect of a structured, dietitian-led education program on patients' general knowledge of phosphate and phosphate binders, and its impact on serum phosphate concentrations in a single-center hemodialysis population.
  
  
  METHODS
  We compared subjects before and after intervention.
  
  
  METHODS
  This study involved two dialysis units operated by a single center.
  
  
  METHODS
  One hundred and fifteen hemodialysis patients consented to participate in this study (54% male; mean age, 61.1 years; 32% Asian). Patients acted as their own controls. One hundred and eight patients completed the study.
  
  
  METHODS
  All patients completed a questionnaire to assess their knowledge of phosphate and phosphate-binder therapy. Small group teaching sessions were then delivered to patients by a single dietitian, with the aid of a hospital interpreter as required. Patients also received information booklets or audio cassettes translated into Urdu. A second identical questionnaire was completed a month later.
  
  
  METHODS
  Outcome measures involved pre-education and posteducation knowledge scores, monthly measurements of serum phosphate, calcium, and mean Kt/V, and parathyroid hormone concentrations every 3 months during the 5 month run-in period and subsequent 5-month study period.
  
  
  RESULTS
  The education program significantly improved patients' general knowledge of phosphate and of phosphate-binders (P < .001), especially in patients with a low pretest score and those of South Asian origin. This result was associated with a significant reduction in serum phosphate in patients with hyperphosphatemia (P = .032).
  
  
  CONCLUSIONS
  These findings suggest that a combination of educational initiatives is effective in enhancing patients' knowledge of phosphate and phosphate-binders, and consequently in improving serum phosphate levels in patients with hyperphosphatemia.
authors.affiliation: Department of Renal Medicine, Bradford Teaching Hospitals National Health Service Trust, St. Luke's Hospital, Bradford, United Kingdom. veena.reddy@sth.nhs.uk
authors.forename: Veena
authors.initials: V
authors.lastname: Reddy
authors.forename: Fiona
authors.initials: F
authors.lastname: Symes
authors.forename: Neeraj
authors.initials: N
authors.lastname: Sethi
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Scally
authors.forename: Judith
authors.initials: J
authors.lastname: Scott
authors.forename: Ramla
authors.initials: R
authors.lastname: Mumtaz
authors.forename: John
authors.initials: J
authors.lastname: Stoves
mesh_terms: D002614:Chelating Agents / Q000627:therapeutic use; D004032:Diet; D004046:Dietetics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D054559:Hyperphosphatemia / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010710:Phosphates / Q000097:blood; D006435:Renal Dialysis; D011795:Surveys and Questionnaires
chemical_list: D002614:Chelating Agents; D010710:Phosphates