Improvement of therapeutic compliance in haemodialysis patients with poor phosphorus control and adherence to treatment with binders: COMQUELFOS study.
BACKGROUND
The effectiveness of phosphate binders in daily practice is directly related to therapeutic compliance (TC) by the patient. The goal of this study was to analyse the TC of haemodialysis patients with hyperphosphatemia and its influence on serum phosphorus for 6 months follow up.


METHODS
181 patients were included, who had mean initial phosphate levels (P) >5mg/dl. TC with different phosphate binders was evaluated, considering non-adherent patients those who had <75% of TC, SMAQ scale score of "non-adherent"(Table 1), and P>5mg/dl. Patients who were adherent at baseline visit (BV) left the study, the rest continued to V5 (6 months). TC at baseline and during the follow up (V1-V5) was analysed. Phosphate binders and the evolution of phosphataemia based on treatment were assessed.


RESULTS
103 male and 78 female patients were evaluated, with a mean age of 59.9 (21-86) years. Of these, 39.2% (n=71) were adherent in the BV. Patients older than 60 years of age were more adherent than younger ones (P=.019).Table 6 specifies the causes of non-compliance. The remaining 60.8% of patients (n=110), were non-adherent and continued through to the end of the study. An average of 27.2% of these patients became adherent during the course of the study. Table 7 shows the relative levels of P with TC over successive visits. At the end of the study, mean P levels had decreased by 1.26mg/dl (P<.0001).


CONCLUSIONS
Among HD patients with poor P level control, there is a low level of adherence with phosphorus binder treatment, at 39.2%. Compliance and phosphataemia are improved with different strategies. The decrease of P is higher in adherent patients than in non-adherent patients.
Servicio de Nefrología, Hospital Perpetuo Socorro, Alicante, Spain.
M
M
Dolores Arenas
Rafael
R
Pérez-García
Mazine
M
Bennouna
Ana
A
Blanco
Oscar
O
Mauricio
M Dolores
MD
Prados
José L
JL
Lerma
M
M
Luisa Muñiz
M
M
Belén Martín
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002614:Chelating Agents / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054559:Hyperphosphatemia / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010758:Phosphorus / Q000378:metabolism*; D011446:Prospective Studies; D006435:Renal Dialysis; D011795:Surveys and Questionnaires; D055815:Young Adult; D016903:Drug Monitoring
D002614:Chelating Agents; D010758:Phosphorus