Impact of phosphate binders on medication dosing frequency, timing, and number of prescribed pills in hemodialysis patients

INTRODUCTION: Phosphate binders (PBs) account for a large proportion of the daily pill burden in hemodialysis patients. However, patients do not take them all at once but at several dosing timings. METHODS: We analyzed the dosing timings of all 322 types of oral drugs prescribed to 533 hemodialysis patients. RESULTS: The median daily dosing frequency for all drugs was 6 (4-7) times/day/patient. Patients prescribed PBs had a markedly higher daily dosing frequency than those not taking PBs (7 [5-8] times/day/patient vs. 4 [3-5] times/day/patient, respectively [p < 0.001]). In addition, the ratio of the number of PB pills to other drugs varied greatly at each dosing timing. Furthermore, it was simulated that the daily dosing frequency could be reduced by approximately two times/day/patient by combining the dosing timings of PBs. CONCLUSION: Changing PB dosing timings can reduce the daily dosing frequency, which may lead to improved medication adherence.