Phosphorus Mission Educational Tool - Partnership between EDTNA/ERCA and Sanofi Phosphorus Mission Educational Tool is a software package developed by Sanofi for use by dialysis nurses to educate their patients on how to maintain healthy phosphorus levels. The patients themselves will also have the option of downloading Phosphorus Mission Educational Tool onto their computers or their mobile telephones outside of a clinic setting. EDTNA/ERCA validated and accredited this educational tool.

1. Treatment Compliance, Therapeutic
Education And Phosphorus Mission
Frédérique Quinio

2. Disclosure
Frédérique Quinio has received funding from Sanofi to attend and speak at this educational
symposium. This is the first time funding has been received from Sanofi.

3. Agenda
• Compliance and therapeutic education
• Phosphorus Mission
• Phosphorus Mission demonstration
• Feedback on independent EDTNA validation

4. Chronic Disease & Treatment Compliance
The WHO defines compliance with treatment as « the
concordance between the behaviour of a person (use of
prescribed drugs, diet and changes of behaviour) and the
recommandations of caregivers »
Source: OMS.2003.Adherence to Long Term Therapies:Evidences for Action.OM/MNC/03.01.
www.who.int/chronic_conditions/en/adherencereport.pdf

5. Determinants For Non Compliance
• Socio-demographic factors (age, gender, socio-economic &
professional background, family situation, personality and
psychological state of the patient)
• Belief system (religion, representation of the disease, the
treatment, the role of caregivers)
• Pathology (intensity of symptoms, duration, severity, prognosis)
• Treatment regimen (number of pills, side effects, daily frequency,
drug form, treatment understanding)
Source: OMS.2003.Adherence to Long Term Therapies:Evidences for Action.OM/MNC/03.01.
www.who.int/chronic_conditions/en/adherencereport.pdf

6. Therapeutic Education: Strengthening
Treatment Compliance
• The WHO defines therapeutic education as « all the actions
done to help patients to improve, maintain the skills /
competences they need to manage their lives with a chronic
disease »
• Goals
- allow patients and their environment to better understand the pathology
and the treatments
- co-operate with caregivers
- introduce patient empowerment into their lives to better manage their
disease
- help patients to maintain and improve their quality of life
Source: WHO-Europe report Therapeutic Patient Education- Continuing Education Programs for Health Care Providers in the
field of chronic disease.1996

7. Therapeutic Education: 4 Stages
• Personalised educational diagnosis
• Definition of a personalised education program - identifying
short and long term learning priorities
• Planning and implementing individual sessions and collective
workshops
• Evaluation of learned skills and program flow
Source : Sandrin.B.(2009) : Education thérapeutique du patient : de quoi s’agit il ? . ADSP n° 66 mars 2009

8. Personalised Diagnosis
• Allows the educational team to be aware of the patient’s five
dimensions (bioclinical, cognitive, socio-professional, psychoaffective
and projective)
• Gives healthgivers elements to understand the reality of living with a
chronic disease
– problems experienced
– Prioritized and identified by the patient
– adaptive strategies already developed
– representation of the disease, the treatment and the relation between caregivers
and the patient)
• Strengthens the therapeutic alliance between the patient and the
multi-disciplinary care giver team
Source : Sandrin.B.(2009) : Education thérapeutique du patient : de quoi s’agit il ? . ADSP n° 66 mars 2009

9. Personalised Program
• Joint definition and priorization of learning priorities
• Joint definition of educational goals so to ensure common
aims between patient and health care team
• Establish an « education contract » between patient and
educational team
Source : Sandrin.B.(2009) : Education thérapeutique du patient : de quoi s’agit il ? . ADSP n° 66 mars 2009

10. The Journey In Therapeutic Education
• Presentation of existing programs (themes, frequency,
individual and group modalities, resources, learning tools and
professionals involved in the process)
• Organisation of the patient’s own program (planning
individual and group sessions)
• Assessing procedures for mid and final term evaluations
Source : Sandrin.B.(2009) : Education thérapeutique du patient : de quoi s’agit il ? . ADSP n° 66 mars 2009

11. Assessment And Re-adjustment
• Provided while designing the program
• Occurs during program at different defined stages
– allows a readjustment of already learned skills
– an adaptation to the patient’s learning speed
– consolidation and valorisation of the changes seen during the program
• Necessary for both patient and educational team
• Final evaluation is undertaken at end of patient involvement
in program
Source : Sandrin.B.(2009) : Education thérapeutique du patient : de quoi s’agit il ? . ADSP n° 66 mars 2009

12. What About CKD ?
• Main concerns for both health carers and patients
- Disease understanding
- Understanding dialysis - what is happening during procedure?
- Understanding importance of healthy diet ,
- Informing and communicating with the family (support of family crucial
to help patient cope with CKD diet restrictions)
- Treatment understanding (potassium, phosphate binders, etc.
rationale for use and compliance)
- Liquid restrictions
Source: http/www.ipcem.org/Ressources/PDFress/complet%20dialyse.pdf

13. Goals For The Future Of CKD Patients’
Support Teams
• Bring knowledge with attractive, interactive, useful and easy
to use methods
• Promote life style changes according to patient’s reality and
needs
• Encourage sharing of patient experience between key
stakeholders (expert patient, support groups, alternative
educational methods, etc.)
• Empower patient and their environment to help them cope
with disease

14. Phosphorus Mission
• Phosphorus Mission is a mobile application designed and
developed by Sanofi for people with advanced chronic kidney
disease (CKD)
• Phosphorus Mission helps patients better understand their
disease, treatment options and dietary choices related to their
health
• Phosphorus Mission enables patients to better assimilate
essential information on CKD and understand the impact of food
choices and the role of prescribed treatments

15. CONNECTING NURSES | 15
The Information Shareapy Community gives access to
practice tips and best practice information gleaned
by nurses and KOL nursing organizations. By
uploading and sharing links on the platform, every
single nurse can make patient support tools and
materials available to their peers and patients.
Nurses can share their education, practice and
research projects on Care Challenge and discover
their colleagues innovations worldwide : they get
immediate visibility and recognition
• Connecting Nurses is a worldwide recognition program for nurses supported by
sanofi, built in partnership with nursing organizations as
International Council of Nurses and EDTNA
• Discover both web platforms through the www.connecting-nurses.com portal and post
your project in Renal Care NOW : your project might be championed in May 2015

16. 16

17. Powered by
Phosphorus Mission Educational Tool Validation
Survey

18. Phosphorus Mission
• April 2014 EDTNA/ERCA members validated Phosphorus Mission via
on line survey
• Responses were anonymous and based on members reviewing PC
version of Phosphorus Mission
• Survey five areas:
• Patient educational challenges in pre dialysis and dialysis patients
• Overall impressions of Phosphorus Mission
• Feedback on individual sections of Phosphorus Mission
• The best location to use Phosphorus Mission
• Ease of use
• https://fr.surveymonkey.com/s/ValidationCommitteePhosphorusMissioneducationaltool

19. Country Feedback
• Belgium
• Greece
• Israel
• Netherlands
• Poland
• Slovenia
• Spain
• Sweden
• UK
• Two skipped country responses

20. Three Main Challenges: Life Style Changes, Treatment
Compliance & Change To Low Phosphate Diet
Answered: 10 Skipped: 2
What do you see as the biggest patient education challenges for your pre-dialysis patients?

21. Three Main Challenges: Lifestyle Change, Change To
Low Phosphate Diet & Treatment Compliance
Answered: 10 Skipped: 2
What do you see as the biggest patient education challenges for your dialysis patients?

22. Phosphorus Mission Valuable For Nurses
Answered: 9 Skipped: 3
How would you rate the usefulness of Phosphorus Mission as an education tool ?

23. Good Acceptance By Nurses
Answered: 9 Skipped: 3
Based on your experience how likely do you think other dialysis nurses will use the
Phosphorus Mission educational tool?

24. Value For Other Clinical Team Members
Answered: 9 Skipped: 3
What other disciplines would find the Phosphorus Mission educational tool useful?

25. What Did You Like Most About Phosphorus Mission?
“ Animation”
“It really makes you think about how hard it is to keep phosphate down with high
phosphate foods”
“Interesting, raising awareness about phosphorus and possible complications”
“Patient friendly” “Simplicity”
“Fun, and looked easy to use. made the
subject enjoyable not a chore”
“Useful as a guide for clinical practice”
“The possibility to find extra information and explication
during and after the game”
“”
The clearness of illustrations contents