Health information technology (IT) to improve the care of patients with chronic kidney disease (CKD)

Diamantidis, Clarissa J.; Becker, Stefan

doi:10.1186/1471-2369-15-7

Cited by 100 publications

(87 citation statements)

References 55 publications

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“…Participants identified the difficulties inherent in living rurally, but also the opportunities that technology provide in terms of using tools such as the internet and telephone sessions to get around both of these challenges. The willingness of this sample to use such tools is encouraging, as it shows that a shift may be beginning to occur in this patient group, unlike in the past when chronic disease populations have used the internet less than healthy adults [53] and did not wish to use tools like mobile phones [54] or the internet to receive support with their disease [55, 56]. It is worth noting, however, that participants who identified the internet as a useful tool through which to receive SMS in this study were respondents to the online version of the survey, who may be more engaged with modern technology.…”

Section: Discussionmentioning

confidence: 99%

Person-centred care in chronic kidney disease: a cross-sectional study of patients’ desires for self-management support

Douglas

Bonner

2017

BMC Nephrol

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BackgroundPeople with chronic kidney disease (CKD) must self-manage their illness to assist with slowing disease-progression, but this is a complex task requiring support from healthcare professionals. Despite the established importance of person-centred care, people with CKD are rarely consulted regarding their desires for self-management support (SMS).MethodsA cross-sectional survey was conducted face-to-face in a Queensland primary care clinic and distributed Australia-wide via an online interface promoted by Kidney Health Australia during 2015. Participants were ≥18 years old and had a self-reported doctor’s diagnosis of CKD (any stage; N = 97). The survey was based upon existent literature which identified 10 areas that those with CKD believe require additional support. Descriptive data were generated and Mann-Whitney U tests were performed to compare the desires of different groups of participants.ResultsOf the 97 participants, 36 completed a hardcopy survey in clinic, and 61 completed the online version. Just over half (60.8%) were female, age ranged from 16–89 (M = 56.44), and time since diagnosis ranged from just diagnosed to 60 years (Mdn = 8.08 years). Strong interest in receiving additional support across all 10 areas was reported (Mdns = 8.00–10.00), with “keeping a positive attitude and taking care of mental and physical health” receiving the highest rating. Those who were: younger (p < .001); more highly educated (p < .001); working (p < .001); diagnosed longer ago (p = .015); and women (p = .050) expressed stronger overall desire for additional support.ConclusionsIn addition to information about CKD and medications, everyday strategies ought to be prioritised in patient education. Varying levels of engagement and eagerness to learn more about self-management highlight the need for a person-centred approach to SMS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-016-0416-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Person-centred care in chronic kidney disease: a cross-sectional study of patients’ desires for self-management support

Douglas

Bonner

2017

BMC Nephrol

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“…These benefits are key aspects of the chronic care model and are critical to the long-term management of CKD (13,16,72,73). Portals may be particularly valuable in complex, chronic disease states, for which they offer patients the opportunity to review medications, laboratory results, and clinical guidance repeatedly and at their convenience (23,74).…”

Section: Discussionmentioning

confidence: 99%

Disparities in Electronic Health Record Patient Portal Use in Nephrology Clinics

Jhamb

Cavanaugh

Bian

et al. 2015

Clinical Journal of the American Society of Nephrology

126

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Background and objectives Electronic health record (EHR) patient portals allow individuals to access their medical information with the intent of patient empowerment. However, little is known about portal use in nephrology patients. We addressed this gap by characterizing adoption of an EHR portal, assessing secular trends, and examining the association of portal adoption and BP control (,140/90 mmHg).Design, setting, participants, & measurements Patients seen between January 1, 2010, and December 31, 2012, at any of four university-affiliated nephrology offices who had at least one additional nephrology follow-up visit before June 30, 2013, were included. Sociodemographic characteristics, comorbidities, clinical measurements, and office visits were abstracted from the EHR. Neighborhood median household income was obtained from the American Community Survey 2012.Results Of 2803 patients, 1098 (39%) accessed the portal. Over 87% of users reviewed laboratory results, 85% reviewed their medical information (e.g., medical history), 85% reviewed or altered appointments, 77% reviewed medications, 65% requested medication refills, and 31% requested medical advice from their renal provider. ConclusionWhile portal adoption appears to be increasing, greater attention is needed to understand why vulnerable populations do not access it. Future research should examine barriers to the use of e-health technologies in underserved patients with CKD, interventions to address them, and their potential to improve outcomes.

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“…Peters (34) emphasized the importance of the patient understanding the need for prompt communication with his or her home dialysis unit when a problem is encountered and stressed the need for patients to receive clear guidelines on when, what, and with whom to communicate. Apart from the traditional telephone call, there are newer methods of communication, including telehealth, texting, and e-mail (35)(36)(37)(38). Moreover, home dialysis patients today may have access to their own electronic personal health records (39) and, thus, potentially have more involvement in their own care.…”

Section: Safety and Communicationmentioning

confidence: 99%

A Syllabus for Teaching Peritoneal Dialysis to Patients and Caregivers

et al. 2016

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ISPD GUIDELINES/RECOMMENDATIONSBeing aware of controversies and lack of evidence in peritoneal dialysis (PD) training, the Nursing Liaison Committee of the International Society for Peritoneal Dialysis (ISPD) has undertaken a review of PD training programs around the world in order to develop a syllabus for PD training. This syllabus has been developed to help PD nurses train patients and caregivers based on a consensus of training program reviews, utilizing current theories and principles of adult education. It is designed as a 5-day program of about 3 hours per day, but both duration and content may be adjusted based on the learner. After completion of our proposed PD training syllabus, the PD nurse will have provided education to a patient and/or caregiver such that the patient/caregiver has the required knowledge, skills and abilities to perform PD at home safely and effectively. The course may also be modified to move some topics to additional training times in the early weeks after the initial sessions. Extra time may be needed to introduce other concepts, such as the renal diet or healthy lifestyle, or to arrange meetings with other healthcare professionals. The syllabus includes a checklist for PD patient assessment and another for PD training. Further research will be needed to evaluate the effect of training using this syllabus, based on patient and nurse satisfaction as well as on infection rates and longevity of PD as a treatment. . Based on the principles of adult learning, these guidelines established a broad description of a course and a set of proposals to aid the teacher/nurse (hereafter called the PD nurse). The committee currently believes that, while the recommendations are still relevant and agree with current teaching practices in PD clinics, there is a need for a more comprehensive course to guide PD nurses.The 2006 Guidelines tried to answer some questions that arise when talking about PD training: Who should be the trainer? Who is the learner? What should be taught? Where should the training occur? What should be the duration of training? How should the patient be taught? However, many of these questions remain unanswered. A search in PubMed using the words "training," "patient education," "peritoneal dialysis," and "peritonitis" found only 17 articles published in the last 5 years, and most of these were about infection prevention. Only 4 were published in the last 12 months. Of these 1 article was a narrative review of the literature of educational interventions in PD which concluded that the topic remained an under-studied aspect of PD (2); another looked at the impact of training hours on infection and suggested a minimum of 15 hours training, to be done before catheter implantation or more than 10 days after (3), and the remaining 2 looked at preventing PD infections (4,5). One further observational study, by Firanek et al., analyzing best practices for nurse-led PD training programs for patients on automated peritoneal dialysis (APD) in the United States, stated that best practices...

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Health information technology (IT) to improve the care of patients with chronic kidney disease (CKD)

Cited by 100 publications

References 55 publications

Person-centred care in chronic kidney disease: a cross-sectional study of patients’ desires for self-management support

Person-centred care in chronic kidney disease: a cross-sectional study of patients’ desires for self-management support

Disparities in Electronic Health Record Patient Portal Use in Nephrology Clinics

A Syllabus for Teaching Peritoneal Dialysis to Patients and Caregivers

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