Poster Topical Area: Medical Nutrition
Location: Hall D
Poster Board Number: 637
Hyperphosphatemia is a major cause of complications in hemodialysis (HD) patients. Dietary phosphorus restriction and phosphorus binders are effective in lowering phosphorus concentrations, but hyperphosphatemia persists, due in part to treatment non-adherence. Our study examined the feasibility and acceptability of using mobile technology to deliver three phosphorus management interventions of varying intensity in HD patients with hyperphosphatemia.
A total of 28 participants were randomized to one of three groups: (1) education (EDU) (n=10), (2) education plus self-monitoring (SM) (n=9), and (3) education and self-monitoring plus social cognitive theory (SCT)-based counseling (COMBINED) (n=9). Education sessions consisted of four short videos shown weekly. An iPad was given to SM and COMBINED to record dietary intakes in MyNetDiary. The COMBINED group also received SCT-based videos. Intervention activities ceased at 12 weeks, but SM and COMBINED groups were encouraged to self-monitor for 24 weeks. Participant's satisfaction was assessed by two 5-point Likert-scale surveys at 24 weeks.
Six participants were lost to follow up and were not included in the analysis. The sample was predominantly white (46.4%) or African American (42.9%) and male (75%), with a mean age of 62.2 (13SD) years. The proportion of participants who logged at least one meal a week during the 12-week intervention and 12 weeks post-intervention was 65% and 28%, respectively. SM and COMBINED groups did not exhibit a significant difference in self-monitoring adherence. Participants reported (agree or strongly agree): receiving enough training in using iPad (88%), ease in using iPad touch screen (94%) convenience of using iPad away from home(81%), and desire to continue using iPad to monitor health (63%); technology-based self-monitoring helped them understand how to change their diet (69%), keep track of nutrition (81%), and stay motivated (63%).
Technology-based behavioral intervention and self-monitoring are feasible and acceptable in a HD population, but adherence declines following active intervention withdrawal. Additional research is needed to determine the level of contact required to sustain engagement, and evaluate technology-based interventions in this population.
The behavioral management of phosphorus in hemodialysis study was supported by the following grant: NIH-R21-DK105437-01
Research Data Associate
New York University Langone Health
Astoria, New York