Until recently, this behaviour change intervention method had not been tested in a patient group experiencing a long-term condition like renal failure. In a recent pilot study (UKCRN Portfolio study 74185), the team evaluated the potential for a self-affirmation intervention to promote improved phosphate medication adherence among non-adherent patients. Interim results from this study have highlighted key issues for which further research is necessary. Firstly, this intervention is known to be more effective in people with low motivation and this informed the recruitment strategy, targeting patients who appeared (on the basis of high serum phosphate levels) to be non-adherent in taking their phosphate medication. However, despite the patient sample's higher average phosphate levels, the majority of the patient group reported to be motivated to improve phosphate control. Therefore, it is likely that for many of these patients there are other reasons for their higher average phosphate levels, such as forgetting to take their medication. In the group of patients who did report low motivation to taking their medication (25% of the sample), the effects of the self-affirmation were observed. There was a trend for patients who self-affirmed, to report the health-risk message to be higher quality; greater self-efficacy and intention to improve phosphate control and ultimately their serum phosphate levels were significantly reduced at one month compared with the control group. It is important to now test the intervention with a larger group of patients reporting low motivation towards the required health behaviour. The team identified another treatment (fluid management) that most renal patients must follow and evaluated 93 patients' thoughts about managing their fluid intake. The results of this brief study suggest that a larger proportion of patients are less motivated to manage their fluid intake and therefore, assessing the feasibility and efficacy of the self-affirmation intervention would be achievable in this treatment group. Fluid management is a central adherence issue to address as it is not only clinically very important but it is a particularly difficult aspect of treatment for patients to manage.