A preference study: calcium acetate tablets versus gelcaps in hemodialysis patients

End stage renal disease (ESRD) patients are frequently noncompliant with phosphate binder therapy. This noncompliance may lead to uncontrolled hyperphosphatemia, resulting in an increased risk of mortality via the development of serious comorbid conditions. A new gelcap form of calcium acetate has been introduced for control of hyperphosphatemia. This single center, unblinded study compared calcium acetate tablets versus calcium acetate gelcaps with regards to patient preference and ease of swallowing. Twenty-two patients were randomized to receive 1 day of treatment with calcium acetate tablets, followed by 1 day of treatment with calcium acetate gelcaps, or vice versa. Following completion of the treatment period, the patients were given a questionnaire to complete that asked them to compare their experience with both treatments. Twenty patients completed the study. Eighteen patients preferred the gelcap to the tablet in all preference categories. The same 18 patients responded that the gelcap was easier to swallow than the tablet. Because of the evidence documenting the noncompliant behavior of ESRD patients with respect to their binder therapy, efforts made to give the patients a more satisfying alternative can aid in improving compliance.