【Abstract】Objective To investigate the effect of the simplified medication adherence questionnaire (SMAQ) in improving treatment compliance with oral phosphorus binding-agent in maintenance hemodialysis (MHD) patients. Methods A total of 95 MHD patients complicated with hyperphosphatemia and admitted to Dandong First Hospital in the period from January 2018 to December 2018 were enrolled in this study. According to the random number table method, they were divided into the SMAQ group (n=46) and the control group (n=49). Both groups were treated with oral phosphorus binding agent and routine nursing. Patients in the SMAQ group were treated with SMAQ during nursing process and the intervention lasted 3 months. Serum phosphorus (SP) control rate, serum calcium (SCa), serum phosphorus (SP), calcium-phosphorus product (Ca×P), intact parathyroid hormone (iPTH) and adverse reactions were compared between the groups before and after the intervention. Results After the intervention, the SMAQ scores were significantly improved (χ2=32.687, P＜0.001), SP control rate was higher in the SMAQ group than in the control group (χ2=28.599, P＜0.001), SP (t=-2.956, P=0.004) and Ca×P value (t=-2.744, P=0.007) were lower in the SMAQ group than in the control group, and iPTH was also lower in the SMAQ group than in the control group but without statistical significance (430.2 pg/ml vs. 543.8 pg/ml; t=-1.287, P=0.201). SCa was similar between the two groups (t= -0.261, P=0.795). Conclusion The application of SMAQ among MHD patients can effectively improve their compliance with oral phosphorus-binding agent.