title: [Evaluation of educational interventions with dialysis patient].
abstract: The treatment of end-stage renal disease requires a significant number of drug treatments. At patient level, daily management is somewhat difficult: Number of prescribed pills, medication side effects, treatment of asymptomatic diseases… The objective of the study was to investigate the effect of guidance tailored to each patient receiving hemodialysis, performed by the pharmacist (educational interventions). Adult haemodialysis patients with hyperphosphatemia despite phosphate binders were eligible for study entry. The study was controlled with a retrospective group. The primary end point was a change in serum phosphate levels. The secondary end points were therapy adherence, knowledge regarding phosphate management and patient satisfaction with the programme. Sixteen patients in each group participated in the study. The mean serum phosphate level at endpoint was decreased by 0.25 mmol/L in the intervention group (0.41 mmol/L for patients with expectancy for this reduction) and by 0.11 mmol/L in the control group. Five patients normalized their serum phosphate level in the intervention group against three patients in the control group. The mean score of adherence decreased from 1.75 to 1.50. The main factors affecting adherence were forgetfulness or carelessness in taking medications and number of daily doses. This study showed the feasibility of an improvement in serum phosphate level and adherence driven by therapeutic education, though effect was highly amplified by the motivation induced by pharmaceutical guidance. Patients emphasize the importance of the involvement of pharmacist in their care.
authors: Service pharmacie, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France. Electronic address: parmier.m@chu-toulouse.fr.
authors: Matthieu
authors: M
authors: Parmier
authors: Service pharmacie, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
authors: Bénédicte
authors: B
authors: Gourieux
authors: Service de néphrologie, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
authors: Thierry
authors: T
authors: Krummel
authors: Service de néphrologie, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
authors: Dorothée
authors: D
authors: Bazin-Kara
authors: Service pharmacie, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
authors: Anne
authors: A
authors: Dory
authors: Service de néphrologie, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France; Faculté de médecine, université de Strasbourg, 4, rue Kirschleger, 67085 Strasbourg cedex, France.
authors: Thierry
authors: T
authors: Hannedouche
mesh_terms: D000328:Adult; D000368:Aged; D002614:Chelating Agents / Q000627:therapeutic use; D005240:Feasibility Studies; D005260:Female; D005440:Fluid Therapy; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D054559:Hyperphosphatemia / Q000097:blood / Q000188:drug therapy / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010593:Pharmaceutical Services; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D002614:Chelating Agents
keywords: Educational intervention; Haemodialysis; Hémodialyse; Intervention éducative; Médicaments chélateurs de phosphate; Phosphate binders