Person-Centered Kidney Education: The Path Forward

Ladin, Keren; Rossi, Ana P.

doi:10.1016/j.xkme.2020.08.001

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…40 It is also noteworthy that our study calls for development of CKD education programs run by a multidisciplinary team, including nephrologists, dietitians, and other peers with CKD. 20,41 In particular, to further verify and implement our findings, more participatory methods that involve patients and caregivers throughout research and interventions are needed. 42 In summary, our study sheds light on patient preferences for a CKD education program in terms of topics, depth, modality, frequency, and type of instructor.…”

Section: Discussionmentioning

confidence: 93%

Exploring Patient Needs and Preferences in CKD Education: A Cross-Sectional Survey Study

Allen,

Nakonechnyi,

Phan

et al. 2024

Kidney360

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Background: Despite efforts to educate individuals with chronic kidney disease (CKD) and thereby improve outcomes, studies have shown that a significant number of patients still report poor CKD knowledge. Thus, understanding patient needs and preferences is crucial for the development and implementation of an effective CKD educational program. Methods: A paper survey was distributed to CKD patients ≥ 21 years at a tertiary care hospital's outpatient nephrology clinic in Rochester, New York. Data on patient demographics, print and technological literacies, and preferences regarding topics, instructors, class formats, session frequency, duration, and peer support were gathered. Results: Of the 337 patients, the mean age was 65 years (± 12.33 years), and the self-identified races were: American Indian or Alaska Native (<1%), Asian (3%), Black or African American (12.17%), Native Hawaiian or other Pacific Islander (<1%), White (83%), and Other (2%). Most patients (69%) never needed help with health instructions and 68% of patients used a smartphone or computer everyday. Key topics identified by patients included the definitions of CKD, creatinine, GFR and kidney diet. 73% of patients desired more than basic CKD information with 1 in 5 even wanting to know “everything a doctor knows.” 46% were willing to attend classes and 33% preferred using digital (video, computer, smartphone) modalities. Patients were willing to attend an average of 3.6 classes and, most preferred hour-long classes. Most patients (46%) preferred a doctor as educator and 53% expressed interest in connecting with fellow patients for peer support. Conclusion: Most CKD patients are interested in comprehensive education about their disease. This research may offer insights into the optimal content and delivery of CKD educational programs by elaborating on patients’ needs and the integration of online modalities to deliver content. Future person-centered educational programs for people with CKD are needed.

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Section: Discussionmentioning

confidence: 93%

Exploring Patient Needs and Preferences in CKD Education: A Cross-Sectional Survey Study

Allen,

Nakonechnyi,

Phan

et al. 2024

Kidney360

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show abstract

mentioning

confidence: 99%

“…Approximately 15% of the adult population in the United States are estimated to have chronic kidney disease, but as many as 9 in 10 adults with the condition do not know they have it. 1 By 2016, nearly 700 000 people in the United States were living with end‐stage renal disease (ESRD). 2 Patients with kidney disease are susceptible to variations in drug exposure 3 ; when treated at the same dose, circulating drug concentrations can differ between individuals with renal impairment and those with normal kidney function.…”

mentioning

confidence: 99%

Single‐dose Pharmacokinetics of Eluxadoline in Healthy Participants With Normal Renal Function and Participants With Renal Impairment

Boinpally

Weissman

2022

Clinical Pharm in Drug Dev

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Eluxadoline is approved for the treatment of diarrhea‐predominant irritable bowel syndrome in the United States. The impact of renal impairment on the pharmacokinetic (PK) parameters of eluxadoline is currently unknown. This phase 1, open‐label, parallel‐group study evaluated the PK and safety profile of eluxadoline in 8 participants with renal impairment and 8 matched healthy controls. Of the participants with renal impairment, 2 had severe renal impairment (estimated glomerular filtration rate [eGFR] <30 mL/min/1.73 m2) and 6 had end‐stage renal disease while not yet on dialysis (eGFR <15 mL/min/1.73 m2). The primary objective was to assess plasma and urine PKs, and plasma protein binding of eluxadoline. In participants with renal impairment, mean plasma concentrations of eluxadoline were consistently higher compared with matched healthy controls: 1.4‐fold higher for mean maximum plasma concentration (Cmax) and 2.2‐fold higher for mean area under the plasma concentration‐time curve from time 0 to time t. The median time to Cmax was 2.5 hours in both groups. Although eluxadoline is a locally acting drug with low oral bioavailability, because of the increased systemic exposure in participants with renal impairment as a cautionary measure the lower approved dose of 75 mg twice daily is recommended for individuals with severe renal impairment and end‐stage renal disease while not yet on dialysis. Eluxadoline 100 mg single dose was well tolerated in participants with renal impairment and matched healthy controls.

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AI-Driven Patient Education in Chronic Kidney Disease: Evaluating Chatbot Responses against Clinical Guidelines

Acharya,

Alba,

Krisanapan

et al. 2024

Diseases

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Chronic kidney disease (CKD) patients can benefit from personalized education on lifestyle and nutrition management strategies to enhance healthcare outcomes. The potential use of chatbots, introduced in 2022, as a tool for educating CKD patients has been explored. A set of 15 questions on lifestyle modification and nutrition, derived from a thorough review of three specific KDIGO guidelines, were developed and posed in various formats, including original, paraphrased with different adverbs, incomplete sentences, and misspellings. Four versions of AI were used to answer these questions: ChatGPT 3.5 (March and September 2023 versions), ChatGPT 4, and Bard AI. Additionally, 20 questions on lifestyle modification and nutrition were derived from the NKF KDOQI guidelines for nutrition in CKD (2020 Update) and answered by four versions of chatbots. Nephrologists reviewed all answers for accuracy. ChatGPT 3.5 produced largely accurate responses across the different question complexities, with occasional misleading statements from the March version. The September 2023 version frequently cited its last update as September 2021 and did not provide specific references, while the November 2023 version did not provide any misleading information. ChatGPT 4 presented answers similar to 3.5 but with improved reference citations, though not always directly relevant. Bard AI, while largely accurate with pictorial representation at times, occasionally produced misleading statements and had inconsistent reference quality, although an improvement was noted over time. Bing AI from November 2023 had short answers without detailed elaboration and sometimes just answered “YES”. Chatbots demonstrate potential as personalized educational tools for CKD that utilize layman’s terms, deliver timely and rapid responses in multiple languages, and offer a conversational pattern advantageous for patient engagement. Despite improvements observed from March to November 2023, some answers remained potentially misleading. ChatGPT 4 offers some advantages over 3.5, although the differences are limited. Collaboration between healthcare professionals and AI developers is essential to improve healthcare delivery and ensure the safe incorporation of chatbots into patient care.

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Person-Centered Kidney Education: The Path Forward

Abstract: M ore than 37 million (15%) adults in the United States have chronic kidney disease (CKD). 1 CKD often is silent and frequently goes undetected until its advanced stages, even in high-risk subgroups such as adults 60 years and older, those

Cited by 3 publications

References 16 publications

Exploring Patient Needs and Preferences in CKD Education: A Cross-Sectional Survey Study

Exploring Patient Needs and Preferences in CKD Education: A Cross-Sectional Survey Study

Single‐dose Pharmacokinetics of Eluxadoline in Healthy Participants With Normal Renal Function and Participants With Renal Impairment

AI-Driven Patient Education in Chronic Kidney Disease: Evaluating Chatbot Responses against Clinical Guidelines

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