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BioMed Research International
Volume 2013 (2013), Article ID 104892, 8 pages
http://dx.doi.org/10.1155/2013/104892
Clinical Study

Clinical Benefits of an Adherence Monitoring Program in the Management of Secondary Hyperparathyroidism with Cinacalcet: Results of a Prospective Randomized Controlled Study

1Division of Nephrology, Department of Medicine, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 17, 1011 Lausanne, Switzerland
2AARDEX Group Ltd., Rue des Cyclistes Frontiére 24, B4600 Visé, Belgium

Received 2 April 2013; Revised 5 June 2013; Accepted 9 June 2013

Academic Editor: Christian-Heinz Anderwald

Copyright © 2013 Valentina Forni Ogna et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims. One of the causes of uncontrolled secondary hyperparathyroidism (sHPT) is patient’s poor drug adherence. We evaluated the clinical benefits of an integrated care approach on the control of sHPT by cinacalcet. Methods. Prospective, randomized, controlled, multicenter, open-label study. Fifty hemodialysis patients on a stable dose of cinacalcet were randomized to an integrated care approach (IC) or usual care approach (UC). In the IC group, cinacalcet adherence was monitored using an electronic system. Results were discussed with the patients in motivational interviews, and drug prescription adapted accordingly. In the UC group, drug adherence was monitored, but results were not available. Results. At six months, 84% of patients in the IC group achieved recommended iPTH targets versus 55% in the UC group ( ). The mean cinacalcet taking adherence improved by 10.8% in the IC group and declined by 5.3% in the UC group ( ). Concomitantly, the mean dose of cinacalcet was reduced by 7.2 mg/day in the IC group and increased by 6.4 mg/day in the UC group ( ). Conclusions. The use of a drug adherence monitoring program in the management of sHPT in hemodialysis patients receiving cinacalcet improves drug adherence and iPTH control and allows a reduction in the dose of cinacalcet.