Effect of Multi-Dimensional Education on Disease Progression in Pre-Dialysis Patients in China

Abstract

Background: There is an increasing body of evidence showing that educational interventions aiming at empowering patients are successful in chronic disease management. The aim of this study was to conduct an evaluation of the systematic effectiveness of a multi-dimensional education intervention program in a group of pre-dialysis chronic kidney disease (CKD) patients. In addition, we investigated whether the outcome of the program was related with the amount of education. Methods: We collected data retrospectively from 302 patients with CKD stages 3, 4, and 5, who were followed up from February 2006 to March 2008. The patients were divided into long-time education group and short-time education group depending on the number of provided hours of education. Survival analysis was undertaken to see if the progression of the kidney function differed between these two groups. Results: The percentage of patients receiving long-time education was highest with severe degree of impairment of renal function (45.5%, 61.3%, and 66.7% in CKD stages 3, 4, and 5 groups, respectively). In a multivariate regression analysis, adjusting for age, gender, Charlson comorbidity index, and other traditional risk factors of renal failure, such as smoking, hypertension, and renal function (glomerular filtration rate), the length of time until a decline of renal function by 25% was noted and was significantly shorter in the short-time education group as compared to the long-time education group (p = 0.0334). Conclusion: Multi-component structured empowerment intervention is effective in pre-dialysis CKD patients and may lead to a delay in the progression of kidney disease.

The Impact of Predialysis Patient Education Counseling on Relative Frequencies of Renal Replacement Modalities

“…The multi-dimensional educational programs for predialysis patients have also been found to have positive effects on the progression of the disease. Programs that provide not only basic knowledge but also coping skills, emotional support, motivation, and encouragement can lead to delay in the progression of the disease and even possible prevention [ 8 ]. The multidisciplinary predialysis education (MPE) is also reported to be associated with a significant reduction in post-dialysis inpatient and total medical expenditures [ 7 ].…”

“…Hence, the predialysis education program (PDEP) is an integral part of the management and treatment of patients with ESRD. The intent of PDEP is to empower the patients for shared decision-making by equipping them with the required knowledge on the disease process as well as skills and motivation to deal with the treatment, along with providing information regarding potential treatment options, diet, and drug prescriptions [ 8 , 9 , 14 ].…”

Influencia de la consulta de enfermería de enfermedad renal crónica avanzada en pacientes que inician tratamiento renal sustitutivo

“…La educación multidisciplinar prediálisis basado en las directrices NFK/DOQI puede disminuir la incidencias de diálisis y reducir la mortalidad en los pacientes con ERC en la etapa tardía (34) , y puede suponer un retraso en la progresión de la enfermedad renal (35) . A pesar de los beneficios demostrados que aporta esta intervención, en nuestro estudio, un porcentaje de pacientes inferior al 40% fueron atendidos en la consulta de enfermería en la etapa previa al inicio de la TSR.…”

Where Are You Going, Nephrology? Considerations on Models of Care in an Evolving Discipline

“…A great deal of indirect evidence supports this model, advocated by most scientific associations [ 63 , 64 , 65 , 66 , 67 ]. Early referral, timely diagnosis, life-style changes, and education have all been linked to slower CKD progression and improved survival [ 28 , 29 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 68 , 69 , 70 , 71 , 72 , 73 ].…”