Effect of a transtheoretical model-based intervention and motivational interviewing on hyperphosphatemia management via telehealth (TMT program) among hemodialysis patients during the COVID-19 pandemic
Issued Date
2024-01-01
Resource Type
eISSN
22962565
Scopus ID
2-s2.0-85211631751
Journal Title
Frontiers in Public Health
Volume
12
Rights Holder(s)
SCOPUS
Bibliographic Citation
Frontiers in Public Health Vol.12 (2024)
Suggested Citation
Thongsunti A., Silpakit C., Rattananupong T., Kittanamongkolchai W., Sumethpimolchai W., Lohsoonthorn V. Effect of a transtheoretical model-based intervention and motivational interviewing on hyperphosphatemia management via telehealth (TMT program) among hemodialysis patients during the COVID-19 pandemic. Frontiers in Public Health Vol.12 (2024). doi:10.3389/fpubh.2024.1361778 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/102434
Title
Effect of a transtheoretical model-based intervention and motivational interviewing on hyperphosphatemia management via telehealth (TMT program) among hemodialysis patients during the COVID-19 pandemic
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Corresponding Author(s)
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Abstract
Background: Hyperphosphatemia poses a significant risk for cardiovascular diseases and mortality in hemodialysis patients. Non-adherence to phosphate binders and a low-phosphate diet behavior contribute to this issue. Leveraging psychological and behavior change theories has proven effective in addressing many health risks. During the COVID-19 pandemic, face-to-face communication was limited, and telehealth served as a bridge to address healthcare gaps. This study aimed to determine the effect of a transtheoretical model-based intervention and motivational interviewing on hyperphosphatemia management via telehealth (TMT program) among hemodialysis patients during the COVID-19 pandemic. Method: A two-arm parallel randomized controlled trial with assessors blinding involved 80 participants who were stratified block-randomized into either the TMT program group (n = 40) or the control group (Usual care; n = 40). Linear regression was used to compare the two groups on serum phosphorus levels, knowledge of hyperphosphatemia management, and dietary consumption behavior at the 24-week endpoint. The readiness to change (stage of change), self-efficacy, and phosphate binder adherence were assessed using Fisher’s test. Result: The TMT program demonstrated a significant reduction in serum phosphorus levels compared to usual care (mean difference = −1.03, 95% CI = −1.77, −0.29). Additionally, improvement in dietary consumption behavior related to phosphorus-containing foods was also observed (mean difference = 13.48, 95% CI = 8.41, 18.57). Positive effects emerged in the readiness to change (p < 0.001), self-efficacy in the appropriate use of phosphate binders (p = 0.025), and adherence to phosphate binders (p = 0.001) at the 24-week endpoint. However, groups did not differ in knowledge of hyperphosphatemia management (mean difference = 7.02, 95% CI = −1.03, 15.07). Conclusion: The study demonstrated that the TMT program has positive effects on reducing serum phosphorus levels, providing a hyperphosphatemia management strategy for ESRD patients undergoing hemodialysis via telehealth. Clinical trial registration: TCTR20230628003, https://www.thaiclinicaltrials.org.