Increasing Autonomous Motivation in ESRD to Enhance Phosphate Binder Adherence

Vanderbilt University

Status: Completed

Conditions: End Stage Renal Disease

Treatments: Behavioral: Motivational interviewing

Study type: Interventional

Funder types: Other

Identifiers

NCT02215655

141143

Details and patient eligibility

About

Hyperphosphatemia in end-stage renal disease (ESRD) patients is a non-traditional risk factor for all-cause and cardiovascular mortality. Non-adherence to phosphate binders is as high as 74% in ESRD patients and has been shown to be most related to psychosocial factors including attitudes. There is limited data on the influence of attitudes and perceived autonomy support on phosphate binder adherence and these two psychosocial constructs can be positively influenced through the use of motivational interviewing skills to increase autonomous motivation. Furthermore, racial disparities are known to exist in ESRD however and there are still gaps, which exist in understanding the determinants of disparities in adherence in vulnerable patients with ESRD.

In this study, the investigators seek to determine the impact of motivational interviewing on phosphate binder adherence in diverse ESRD patients. The investigators will ask all the subjects to fill out surveys mainly regarding their attitudes; perceived providers' autonomy support and phosphate binder adherence. The investigators will administer motivational counseling to subjects in the intervention arm of the study, at baseline and 1 month after recruitment. The investigators will ask all the subjects to fill out the same surveys 2 months after recruitment and the investigators will compare subjects who underwent motivational interviewing to those who did not.

Enrollment: 150 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adults age 18 years or older
• Receiving phosphate binder therapy currently
• English speaking

Exclusion criteria

• Non- English speaking
• Known diagnosis of psychosis or dementia, limiting ability to provide informed consent
• Any medical condition that precludes participation in the study including deafness, dying etc.
• Initial Morisky Medication Adherence score greater than 6

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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150 participants in 2 patient groups

Motivational interviewing

Active Comparator group

Description:

Motivational interviewing counselling will be administered to the subjects

Treatment:

Behavioral: Motivational interviewing

No intervention: control group

No Intervention group

Description:

No motivational interviewing counselling will be administered to the subjects