Increasing Autonomous Motivation in ESRD to Enhance Phosphate Binder Adherence

Hyperphosphatemia in end-stage renal disease (ESRD) patients is a non-traditional risk
factor for all-cause and cardiovascular mortality. Non-adherence to phosphate binders is as
high as 74% in ESRD patients and has been shown to be most related to psychosocial factors
including attitudes. There is limited data on the influence of attitudes and perceived
autonomy support on phosphate binder adherence and these two psychosocial constructs can be
positively influenced through the use of motivational interviewing skills to increase
autonomous motivation. Furthermore, racial disparities are known to exist in ESRD however
and there are still gaps, which exist in understanding the determinants of disparities in
adherence in vulnerable patients with ESRD.

In this study, the investigators seek to determine the impact of motivational interviewing
on phosphate binder adherence in diverse ESRD patients. The investigators will ask all the
subjects to fill out surveys mainly regarding their attitudes; perceived providers' autonomy
support and phosphate binder adherence. The investigators will administer motivational
counseling to subjects in the intervention arm of the study, at baseline and 1 month after
recruitment. The investigators will ask all the subjects to fill out the same surveys 2
months after recruitment and the investigators will compare subjects who underwent
motivational interviewing to those who did not.