Associations between phosphate binders prescription, illness perception, and depression in hemodialysis patients

Studies among hemodialysis (HD) patients have looked into relationships between illness perception (IP), depression, and adherence yet rarely looked further into medication factors. Those studies were also conducted at urban HD centers leaving out those from a smaller town. Our objective is to determine phosphate binders (PBs) influences on IP and depression among HD population in smaller town. One hundred and thirteen patients from three Central Pahang Cluster Hospitals, Malaysia on HD were interviewed using Malay version of the Brief IP Questionnaire and Beck Depression Inventory II (BDI-II). This study found a significant positive correlation between PBs daily dose frequency with consequence, timeline, and illness concern. Type of PBs used influenced personal control significantly. History of PBs side effects resulted in significantly lower treatment control and lower emotional representation. There was a significant negative relationship between dialysis vintage with both identity and IP score. Depressed patients had significantly higher emotional representation compared to healthy controls. Meanwhile, there was a positive correlation between BDI-II score with coherence, consequence, and emotional representation. Around 23.9% of the patients reported symptoms of depression. Depressed patients had significantly shorter dialysis vintage compared to healthy controls. They tended to report a significant history of hospital admission in the past six months that peaked among those on HD between four to six years. The current study showed the effect of PBs therapy on IP while depression was associated with HD duration and hospital admission. This information can be used to formulate a better treatment approach by health-care practitioners toward better patients treatment hence outcomes.