{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T07:02:56Z","timestamp":1793084576793,"version":"4.5.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002997","name":"Nierstichting","doi-asserted-by":"publisher","award":["22OP+056"],"award-info":[{"award-number":["22OP+056"]}],"id":[{"id":"10.13039\/501100002997","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Clin Pharm"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The PIDO-P (Pharmacist Intervention and Dose Optimization of Phosphate-binding medication) was designed to improve high serum phosphate concentration (SPC) in haemodialysis patients with a high pill burden of phosphate-binding medication (PBM). This intervention consisted of three pharmacist-patient consultations, in which barriers to adherence to PBM were addressed and PBM dose was reduced. Although this intervention improved PBM adherence, SPC remained high.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To determine the implementation fidelity (IF) of the PIDO-P intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This mixed-methods implementation study had a convergent design using the intervention mixed-methods framework. Data from all patients included in the PIDO-P study (n\u2009=\u200975) were used to assess IF using Carroll\u2019s Framework for IF. Six key components were identified [A: identifying barriers, B: assessing medication-related health literacy; C: providing information and advice, D: discussing patient preferences, E: providing a summary\/dose reduction advice, F: performing a follow-up consultation].\u00a0Two researchers independently rated the extent to which the different aspects of the key intervention components were carried out as planned. Data sources were research administration (quantitative and qualitative), oral surveys from patients (quantitative and qualitative) and pharmacists (quantitative), semi-structured interviews with six patients, two pharmacists, and three prescribers (qualitative), and electronic medical records (quantitative). Data from semi-structured interviews were thematically analysed according to Braun and Clarke with Atlas.ti, quantitative data were analysed using descriptive statistics in SPSS.\u00a0Where possible, data integration was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The adherence to the intervention was moderate to high, except for the screening process. The written summary was delivered to a moderate degree (65.3%). Facilitation strategies were helpful, and pharmacists considered the intervention not too complex. The quality of delivery and participant responsiveness were good. Four IF themes could be identified: (1) patient knowledge and understanding, (2) correct use of PBM, (3) PBM treatment individualisation, (4) relationship between pharmacist and patient. To increase its feasibility, the intervention should be targeted at patients with SPC\u2009&gt;\u20092.0 mmol\/L, and patient selection should be improved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The lack of effect of the PIDO-P intervention on SPC cannot be explained by low IF. Targeting patients with higher SPC and improving patient selection may increase its effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11096-025-01995-z","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T13:50:17Z","timestamp":1758894617000},"page":"446-468","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Implementation fidelity of a pharmacist-led intervention program to improve a high serum phosphate concentration in haemodialysis patients: a mixed-methods study"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9537-503X","authenticated-orcid":false,"given":"F. J.","family":"van den Oever","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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In all cases money has been transferred to hospital accounts, and none has been paid to his personal bank accounts.\u202f TvG does not have employment or stock ownership at any of these companies, and neither does he have patents or patent applications. No competing interests are present for the rest of the authors.   This research was partly funded by the Dutch Kidney Foundation (grant identification number 22OP\u2009+\u2009056).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The study was conducted according to the principles of the Declaration of Helsinki (October 2013). The study was assessed by the accredited Medical Ethics Committee (METC) of MEC-U (Medical Ethical Committee Utrecht) and deemed not to be subject to the Medical Research Involving Human Subjects Act (WMO), approval letter W21.142.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All patients provided written informed consent.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}]}}