Lanthanum carbonate oral powder: satisfaction, preference and adherence in French and Spanish patients with end-stage renal disease

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Background: Phosphate binders, such as lanthanum carbonate, control elevated serum-phosphate levels in patients with end-stage renal disease (ESRD). Lanthanum carbonate is available in oral powder and tablet form. The aim of this survey was to investigate satisfaction with, preference for, and adherence to lanthanum carbonate oral powder in patients with ESRD.

Scope: Patients from France and Spain who had been taking lanthanum carbonate powder for at least 4 weeks, and who had experience of other phosphate binders of any formulation, were asked to complete an online or telephone survey. Treatment satisfaction was measured using the Treatment Satisfaction Questionnaire for Medication-9; preference was measured using 5-point Likert scale agreement ratings; and adherence was measured using the Morisky Medication Adherence Scale-4. Data were evaluated using bivariate analyses.

Findings: Overall, 160 patients participated (80 per country). Lanthanum carbonate powder was reported to have a higher effectiveness rating (p<0.05), be more convenient (p<0.05), and provide a higher level of satisfaction (p<0.01) than previous binders. There was an overall preference for lanthanum carbonate powder over previous binders of any formulation (p<0.001). Adherence to medication was similar for all binders analysed: 66.3% of French patients adhered to lanthanum carbonate powder, and 65.0% adhered to previous binder treatment (p=not significant); 52.5% of Spanish patients adhered to lanthanum carbonate powder, and 56.3% adhered to previous binder treatment (p=not significant).

Limitations: The survey enrolled patients who had already experienced phosphate binders before the study began. Information on patient preferences for and adherence to previous phosphate binders was therefore based on the patients’ memories of these experiences, which may have been subject to change over time. Although most participants completed the online survey in this study, a telephone survey was used for individuals who could not access the online version; if only one method of data recording had been used, there may have been reduced variation in responses.

Conclusion: Patients with ESRD report increased satisfaction with and preference for lanthanum carbonate powder over other formulations, suggesting that lanthanum carbonate powder is more convenient and easier to use than other formulations.

Keywords: chronic kidney failure, chronic renal insufficiency, lanthanum carbonate, medication adherence, patient preference, personal satisfaction, powders, phosphates.

Abbreviations: ESRD, end-stage renal disease; MMAS, Morisky Medication Adherence Scale; NS, not significant; SD, standard deviation; TSQM, Treatment Satisfaction Questionnaire for Medication

Citation: Keith M, de Sequera P, Clair F, Pedersini R. Lanthanum carbonate oral powder: satisfaction, preference and adherence in French and Spanish patients with end-stage renal disease. Drugs in Context 2016; 5: 212300. DOI: 10.7573/dic.212300

Disclosure and potential conflicts of interest: Michael Keith was an employee and a stock holder of Shire at the time of the study. Patricia de Sequera has no conflicts of interest to declare. François Clair has received funding from Shire. Riccardo Pedersini was an employee of Kantar Health at the time of the study and is currently an employee of RTI Health Solutions.

The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests forms for the authors are available for download at:

Contributions: All named authors contributed to the conception of the work; the acquisition, analysis, and interpretation of the data; and drafting and revision of the manuscript. All named authors meet the ICMJE criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval of the version to be published.

Acknowledgements: Medical writing support was provided by Noëlle L O’Regan PhD of PharmaGenesis London, London, UK, and was funded by Shire. The results were presented previously as a poster at the 52nd Congress of the European Renal Association – European Dialysis and Transplant Association (ERA-EDTA) in May 2015.

Funding declaration: This study was conducted by Kantar Health and funded by Shire Development LLC.

Compliance with ethics guidelines: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964, as revised in 2013. Informed consent was obtained from all patients for being included in the study.

Copyright: Copyright © 2016 Keith M, de Sequera P, Clair F, Pedersini R. Distributed under the terms of the Creative Commons License Deed CC BY NC ND 3.0, which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2016 Keith M, de Sequera P, Clair F, Pedersini R. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 3.0.

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Correspondence: Riccardo Pedersini, RTI Health Solutions, Travessera de Gracia 56, Atico 1, 08006 Barcelona, Spain. 

Provenance: Submitted, externally peer reviewed

Submitted: 29 July 2016; Peer review comments to author: 30 August 2016; Publication date: 14 October 2016

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