Pilot Study of a Physician-Delivered Education Tool to Increase Patient Knowledge About CKD

Abstract

Background Limited research exists on physician-delivered education interventions. We examined the feasibility and impact of an educational tool on facilitating physician-patient kidney disease communication. Study Design Pilot feasibility clinical trial with a historical control to examine effect size on patient knowledge and structured questions to elicit physician and patient feedback. Setting & Participants Adults with chronic kidney disease (CKD) stages 1–5, seen in nephrology clinic. Intervention One page educational worksheet, reviewed by physicians with patients. Outcomes Kidney knowledge between patient groups and provider/patient feedback. Measurements Patient kidney knowledge was measured using a previously validated questionnaire compared between patients receiving the intervention (April–October 2010) and a historical cohort (April–October 2009). Provider input was obtained using structured interviews. Patient input was obtained through survey questions. Patient characteristics were abstracted from the medical record. Results 556 patients were included, with 401 patients in the historical cohort, and 155 receiving the intervention. Mean age was 57 ± 16 (SD) years, with 53% male, 81% White, and 78% CKD stages 3–5. Compared to the historical cohort, patients receiving the intervention had higher adjusted odds of knowing they had CKD (adjusted OR, 2.20; 95% CI, 1.16–4.17; p=0.01), knowing their kidney function (adjusted OR, 2.25; 95% CI, 1.27–3.97; p=0.005), and knowing their stage of CKD (adjusted OR, 3.22; 95% CI, 1.49–6.92; p=0.003). Physicians found the intervention tool easy and feasible to integrate into practice and 98% of patients who received the intervention recommended it for future use. Limitations Study design did not randomize patients for comparison and enrollment was performed in clinics at one center. Conclusions In this pilot study, a physician delivered education intervention was feasible to use in practice, and was associated with higher patient kidney disease knowledge. Further examination of physician delivered education interventions for increasing patient disease understanding should be tested through randomized trials.

Results of a novel screening tool measuring dietary sodium knowledge in patients with chronic kidney disease

“…The survey was performed as part of a larger study assessing patient knowledge about many aspects of kidney disease, communication, and kidney care [ 27 ]. Initial participants (approximately the first 10–20) were asked to comment on questions to ensure interpretability.…”

Patient activation with knowledge, self‐management and confidence in chronic kidney disease

“…Patients with CKD who have a poor understanding of their disease process tend to participate less in their health care management, which includes making future decisions about dialysis treatment (Wright‐Nunes et al . ). Educating patients on their diagnosis, prognosis and/or treatments, during their office visits, is an important step to engaging patients in their health care (Wright‐Nunes et al .…”

“…Educating patients on their diagnosis, prognosis and/or treatments, during their office visits, is an important step to engaging patients in their health care (Wright‐Nunes et al . ; Cavanaugh ).…”

Clinical decision support improves physician guideline adherence for laboratory monitoring of chronic kidney disease: a matched cohort study

“…Because of manifest necessity for achieving proper care of patients with chronic kidney disease (CKD), extensive guidelines have been created by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI™) [ 10 – 14 ] and the Kidney Disease: Improving Global Outcomes (KDIGO®) Work Groups [ 15 – 19 ]. To-date, few CDSS have attempted to implement them [ 20 – 23 ]. We present here the results of a matched cohort study of a CDSS designed to implement the KDOQI™/KDIGO® guidelines via laboratory-based interpretive reports delivered to community-based physicians as part of their routine laboratory reporting from a single national testing vendor.…”