Type 2 Translational Research for CKD

Tuot, Delphine S.; Corbett, Cynthia F.; Setter, Stephen M.; Powe, Neil R.

doi:10.2215/cjn.00130113

Cited by 13 publications

(13 citation statements)

References 63 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The National Institutes of Health has an initiative in type 2 translation in CKD, which has funded a number of innovative approaches to patient education (113). These include the use of patient navigators, mhealth (e.g., smart phone reminders), multidisciplinary care, and SDM (114). The NKDEP helps disseminate innovative tools developed by National Institute of Diabetes and Digestive and Kidney Diseases-funded investigators to patients, families, and providers, especially those serving high-risk populations as primary care clinicians.…”

Section: Policies and Research To Further Ckd Educationmentioning

confidence: 99%

Educating Patients about CKD

Narva

Norton

Boulware

2016

Clinical Journal of the American Society of Nephrology

204

190

View full text Add to dashboard Cite

Patient education is associated with better patient outcomes and supported by international guidelines and organizations, but a range of barriers prevent widespread implementation of comprehensive education for people with progressive kidney disease, especially in the United States. Among United States patients, obstacles to education include the complex nature of kidney disease information, low baseline awareness, limited health literacy and numeracy, limited availability of CKD information, and lack of readiness to learn. For providers, lack of time and clinical confidence combine with competing education priorities and confusion about diagnosing CKD to limit educational efforts. At the system level, lack of provider incentives, limited availability of practical decision support tools, and lack of established interdisciplinary care models inhibit patient education. Despite these barriers, innovative education approaches for people with CKD exist, including self-management support, shared decision making, use of digital media, and engaging families and communities. Education efficiency may be increased by focusing on people with progressive disease, establishing interdisciplinary care management including community health workers, and providing education in group settings. New educational approaches are being developed through research and quality improvement efforts, but challenges to evaluating public awareness and patient education programs inhibit identification of successful strategies for broader implementation. However, growing interest in improving patient-centered outcomes may provide new approaches to effective education of people with CKD.

show abstract

Section: Policies and Research To Further Ckd Educationmentioning

confidence: 99%

Educating Patients about CKD

Narva

Norton

Boulware

2016

Clinical Journal of the American Society of Nephrology

204

190

View full text Add to dashboard Cite

show abstract

“…National efforts to increase implementation of electronic medical records and electronic prescribing may further increase adherence by identifying patients at risk or with suboptimal adherence, and targeting them for intervention [61]. Finally, several new models of pharmacy care are being evaluated within patient-centered care models, across care transitions through care coordination, and as part of accountable care organizations [62]. Together, these efforts to improve medication use through alignment of financing, regulatory incentives, and evaluation of new care models have tremendous potential to improve the quality of care delivery with a focus on improving medication adherence and safety.…”

Section: New Models Of Care: Including Pharmacistsmentioning

confidence: 99%

New models of chronic kidney disease care including pharmacists

Peter

Wazny

Patel

2013

Current Opinion in Nephrology &Amp; Hypertension

View full text Add to dashboard Cite

Purpose of review Chronic kidney disease patients are complex, have many medication-related problems (MRPs) and high rates of medication nonadherence, and are less adherent to some medications than patients with higher levels of kidney function. Nonadherence in CKD patients increases the odds of uncontrolled hypertension, which can increase the risk of CKD progression. This review discusses reasons for gaps in medication-related care for CKD patients, pharmacy services to reduce these gaps, and successful models that incorporate pharmacist care. Recent findings Pharmacists are currently being trained to deliver patient-centered care, including identification and management of MRPs and helping patients overcome barriers to improve medication adherence. A growing body of evidence indicates that pharmacist services for CKD patients, including medication reconciliation and medication therapy management, positively affect clinical and cost outcomes including lower rates of decline in glomerular filtration rates, reduced mortality, and fewer hospitalizations and hospital days, but more robust research is needed. Team-based models including pharmacists exist today and are being studied in a wide range of innovative care and reimbursement models. Summary Opportunities are growing to include pharmacists as integral members of CKD and dialysis healthcare teams to reduce MRPs, increase medication adherence, and improve patient outcomes.

show abstract

“…This model relies on a robust, health information technology–enabled program that harnesses the electronic medical record to provide specific nephrology decision support to all providers in the system and monitor the delivery of evidence-based practice, such as ACEi/ARB administration and timely placement of vascular access. 58 As such, this technology allows collaboration among clinicians to slow CKD progression and ensure optimal preparation for renal replacement therapy among a high-risk, traditionally underserved population. A different model of enhancing the primary care-nephrology care interface to enhance access to nephrology expertise relies on a “medical neighborhood” of nephrologists who can offer timely and efficient consultations, diagnostic services and needed treatments.…”

Section: Current Initiatives To Enhance Safety-net Ckd Carementioning

confidence: 99%

Chronic Kidney Disease Care in the US Safety Net

Tuot

Grubbs

2015

Advances in Chronic Kidney Disease

Self Cite

View full text Add to dashboard Cite

The US health care system provides a patchwork of services, known as the safety-net, for the uninsured, under-insured and indigent populations who would otherwise have little access to health care services. Individuals who rely on safety-net facilities are from racial/ethnic minority groups, have low socioeconomic status and often have low health literacy and/or and limited English proficiency. They shoulder a disproportionate burden of chronic kidney disease (CKD) in the United States and experience excess CKD-associated morbidity and mortality. Suboptimal delivery of CKD care may be contributing and is an area of active translational research. Several initiatives that show promise in improving safety-net CKD care delivery include those that enhance diagnostic and management skills of primary care providers, rely on comprehensive care management programs led by non-physicians, and leverage technology to enhance patient access to virtual nephrology expertise. Uncovering better ways to translate scientific evidence into practice for vulnerable patients with CKD is a formidable challenge that will require national surveillance of CKD quality measures across diverse ambulatory health systems, including safety-nets. Only then will the nephrology community be to identify and share best practices to enhance health and mitigate disparities of care among patients with CKD.

show abstract

Type 2 Translational Research for CKD

Cited by 13 publications

References 63 publications

Educating Patients about CKD

Educating Patients about CKD

New models of chronic kidney disease care including pharmacists

Chronic Kidney Disease Care in the US Safety Net

Contact Info

Product

Resources

About