Abstract
Medication switching based on patient preferences is expected to improve medication palatability and adherence. This study aimed to evaluate the impact of phosphate binder switching, based on the preferences of patients undergoing HD through collaboration between community pharmacists and physicians, on medication palatability and adherence.
Initially, 50 patients undergoing HD treated with phosphate binders were surveyed regarding palatability using a visual analog scale (VAS). Nine (18%) patients reported difficulty taking medication (VAS score ≤40), and five of eighteen patients with a VAS score ≤50 requested a change in phosphate binders.
Subsequently, phosphate binders were switched based on preferences in seven patients undergoing HD (eight cases), following a phosphate binder switching protocol agreed upon in advance between the community pharmacy and the clinic. Patients were interviewed regarding their willingness to take the phosphate binder-based medication and its palatability using the Numerical Rating Scale (NRS), and their serum phosphate levels were assessed at the community pharmacy before and after the switch. The NRS scores for phosphate binder palatability and medication adherence changed from (median [range]) 5 [2–10] to 7.5 [5–10] (p=0.031) and from 2 [0–5] to 8 [4–10] (p=0.031), respectively, after switching. However, no significant changes in medication adherence or serum phosphate levels were observed in the overall patients. The two patients who were non-adherent to binders before the switch showed improved medication adherence.
In conclusion, this study suggests that switching phosphate binders based on the preferences of patients undergoing HD through collaboration between community pharmacists and physicians can improve medication palatability and adherence. This approach could be particularly effective for patients who were initially not adherent to their phosphate binders.
