Nutritional Education for the Management of Osteodystrophy (Nemo) in Patients on Haemodialysis: A Randomised Controlled Trial

Karavetian, Mirey; Ghaddar, Sana

doi:10.1111/j.1755-6686.2012.00327.x

Cited by 26 publications

(95 citation statements)

References 27 publications

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“…showing the effectiveness of intensive education; this rhymes with published literature on NE interventions [15,21,24]. Knowledge scores of the EP group significantly improved at follow up but did not reach acceptable levels; this might be explained by the contamination of information through patients and nurses.…”

Section: Discussionsupporting

confidence: 69%

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Effect of behavioral stage-based nutrition education on management of osteodystrophy among hemodialysis patients, Lebanon

Karavetian

Vries

Elzein³

et al. 2015

Patient Education and Counseling

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Section: Discussionsupporting

confidence: 69%

“…Sample size was calculated based on a previous publication [15] to detect significant changes in the primary outcome (serum P). All patients in HD units recruited to cluster 2 were assigned to the partial intervention protocol (trained hospital dietitian -THD).…”

Section: Designmentioning

confidence: 99%

Effect of behavioral stage-based nutrition education on management of osteodystrophy among hemodialysis patients, Lebanon

Karavetian

Vries

Elzein³

et al. 2015

Patient Education and Counseling

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“…We based our calculations on the data retrieved from our pilot study [7] where serum P changed significantly from 6.54 to 5.39 mg/dl ( ± 2.0 mg) in the DD intervention group and from 6.16 to 6.51 mg/dl ( ± 1.5 mg) in the control group with no statistical significance. To generate a similar significant effect of the prior in Cluster A of this study, a sample size of 50 patients in each of the intervention and control groups was estimated to achieve 80% power at a 5% alpha.…”

Section: Methodsmentioning

confidence: 99%

“…Literature shows that only 36% of the HD patients are able to adhere to the MNT guidelines [6] and as low as 43% in one important aspect: phosphorus (P) intake recommendations [5]. A study conducted in Lebanon on 122 HD stable patients showed that 57% of them has a serum P > 5.5 mg/dl indicating the lack of adherence [7]. Reported predictors of non-adherence were gender, age, years on dialysis, patient and staff education level, physical limitations, financial limitations, inadequate staffing, and the patient's willingness to cooperate with the staff [8].…”

Section: Introductionmentioning

confidence: 99%

Nutritional education for management of osteodystrophy (NEMO) trial: Design and patient characteristics, Lebanon

et al. 2014

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This study aims to determine the effect of a trained dedicated dietitian on clinical outcomes among Lebanese hemodialysis (HD) patients: and thus demonstrate a viable developing country model. This paper describes the study protocol and baseline data. The study was a multicenter randomized controlled trial with parallel-group design involving 12 HD units: assigned to cluster A (n = 6) or B (n = 6). A total of 570 patients met the inclusion criteria. Patients in cluster A were randomly assigned as per dialysis shift to the following: Dedicated Dietitian (DD) (n = 133) and Existing Practice (EP) (n = 138) protocols. Cluster B patients (n = 299) received Trained Hospital Dietitian (THD) protocol. Dietitians of the DD and THD groups were trained by the research team on Kidney Disease Outcomes Quality Initiative nutrition guidelines. DD protocol included: individualized nutrition education for 2 hours/month/HD patient for 6 months focusing on renal osteodystrophy and using the Trans-theoretical theory for behavioral change. EP protocol included nutrition education given to patients by hospital dietitians who were blinded to the study. The THD protocol included nutrition education to patients given by hospital dietitian as per the training received but within hospital responsibilities, with no set educational protocol or tools. Baseline data revealed that 40% of patients were hyperphosphatemics (> 5.5 mg/dl) with low dietary adherence and knowledge of dietary P restriction in addition to inadequate daily protein intake (58.86%± 33.87% of needs) yet adequate dietary P intake (795.52 ± 366.94 mg/day). Quality of life (QOL) ranged from 48-75% of full health. Baseline differences between the 3 groups revealed significant differences in serum P, malnutrition status, adherence to diet and P chelators and in 2 factors of the QOL: physical and social functioning. The data show room for improvement in the nutritional status of the patients. The NEMO trial may be able to demonstrate a better nutritional management of HD patients.

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“…Educational nursing intervention to reduce the hyperphosphatemia in patients on hemodialysis Stumm EMF, et al team in nephrology, as it may increase morbidity and mortality, and thereby compromise the quality of life of chronic renal patients (14) . Itching is among the clinical conditions secondary to hyperphosphatemia that impact the quality of life of these patients.…”

Section: Introductionmentioning

confidence: 99%

Intervenção educacional de enfermagem para redução da hiperfosfatemia em pacientes em hemodiálise

et al. 2017

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Objective: to evaluate the effectiveness of an educational nursing intervention to reduce hyperphosphataemia in chronic renal patients on hemodialysis. Method: quasi-experimental study with 63 hyperphosphatemic patients on hemodialysis. The intervention consisted of developing and providing a printed and illustrated manual to patients containing information on disease control. The participant was asked to complete a daily checklist with the aim to reinforce aspects provided in the manual. Laboratory tests and itching intensity were analyzed at the beginning of the study, and at 30 and 60 days after the educational intervention. Results: the mean age of participants was 58±13.1 years, with a treatment time of 51.1±44.7 months. A reduction in serum phosphorus values of 7.06 ± 1.43 to 5.80 ± 1.53 (p <0.001) and the intensity of itching after the intervention was observed. Conclusion: the educational nursing intervention was effective in reducing phosphate and decreasing itching in hyperphosphatemic patients. Descriptors: Renal Dialysis; Hyperphosphataemia; Nursing; Hemodialysis; Renal Insuffi ciency, Chronic. RESUMO Objetivo: avaliar a efetividade de uma intervenção educacional de enfermagem para redução da hiperfosfatemia em pacientes renais crônicos em hemodiálise. Método: estudo quase experimental realizado com 63 pacientes hiperfosfatêmicos em hemodiálise. A intervenção se constituiu em orientar e disponibilizar um manual impresso e ilustrado aos pacientes, contendo informações sobre o controle da doença. Foi solicitado o preenchimento de um checklist diário, com fi nalidade recordatória dos aspectos abordados no manual. Os exames laboratoriais e a intensidade do prurido foram analisados no início do estudo, aos 30 e 60 dias após a intervenção educacional. Resultados: a média de idade dos participantes foi 58±13,1 anos e tempo de tratamento de 51,1±44,7 meses. Houve redução dos valores séricos do fósforo de 7,06±1,43 para 5,80±1,53 (p<0,001) e da intensidade do prurido após a intervenção. Conclusão: a Intervenção Educacional de Enfermagem foi efetiva para redução do fosfato e diminuição do prurido nos pacientes hiperfosfatêmicos.

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Nutritional Education for the Management of Osteodystrophy (Nemo) in Patients on Haemodialysis: A Randomised Controlled Trial

Abstract: Our findings demonstrate the importance of patient-tailored counselling on serum P management.

Cited by 26 publications

References 27 publications

Effect of behavioral stage-based nutrition education on management of osteodystrophy among hemodialysis patients, Lebanon

Effect of behavioral stage-based nutrition education on management of osteodystrophy among hemodialysis patients, Lebanon

Nutritional education for management of osteodystrophy (NEMO) trial: Design and patient characteristics, Lebanon

Intervenção educacional de enfermagem para redução da hiperfosfatemia em pacientes em hemodiálise

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