A Systematic Review Of The Prevalence And Determinants Of Nonadherence To Phosphate Binding Medication In Patients With End-stage Renal Disease

Christina Karamanidou; Jane Clatworthy; John Weinman; Rob Horne


BMC Nephrology 

In This Article


Nonadherence to phosphate binding medication is a serious problem; studies report that 22–74% patients are nonadherent with their phosphate binding medication, with the variation attributable to differences in the definition and measurement of nonadherence.

Demographic and clinical factors are not consistently associated with nonadherence to phosphate binding medication, with the exception of age (older patients are more likely to be adherent). However issues such as regimen complexity, which are likely to be important determinants of adherence, have not been fully explored and should be considered in future research.

Across studies, psychosocial factors appear to be the most promising predictors of nonadherence, including patients' beliefs about their treatment and their perceived social support. However, limitations in research design and study power create the need for further methodologically sound studies to identify the key beliefs influencing nonadherence to phosphate binders as a basis for the development of interventions to facilitate motivation, informed choice and appropriate adherence.


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