Assessment of Printed Patient-Educational Materials for Chronic Kidney Disease

Abstract

Background: Awareness of chronic kidney disease (CKD) is suboptimal among patients with CKD, perhaps due to poor readability of patient education materials (PEMs). We reviewed the suitability and readability of common PEMs that focused on 5 content areas: basics of CKD, risk factors for CKD development, risk factors for CKD progression, complications of CKD and self-management strategies to improve kidney health. Methods: Three reviewers (nephrologist, primary care physician, patient) used the Suitability Assessment of Materials to rate PEMs on message content/stimulation of learning, typography, visuals and layout and determined literacy level. Mean ratings were calculated for each PEM by content area and overall (superior = 70-100; adequate = 40-69; inadequate = <40). Linear regression was used to determine the impact of literacy level on mean rating. Results: We reviewed 69 PEMs from 19 organizations, divided into 113 content area sections. Most (79%) PEM sections were ‘adequate' (mean rating, 58.3%). Inclusion of patient-centered content and opportunities for patient interaction were associated with ‘superior' ratings. Mean ratings (SD) were similar across content areas: basics of CKD, 58.9% (9.1); risk factors for CKD development, 57.0% (12.3); risk factors for CKD progression, 58.5% (12.0); CKD complications, 62.3% (15.7), and self-management strategies, 62.2% (12.3). ≤6th grade literacy level (vs. >6th grade) was associated with an 11.7 point higher mean rating. Conclusion: Most PEMs for kidney disease were adequate. Outstanding PEMs shared characteristics of patient centeredness, a low literacy level, and patient interaction. Providers should be aware of strengths and limitations of PEMs when educating their patients about CKD.

Variation in Patients’ Awareness of CKD according to How They Are Asked

“…CKD awareness campaigns that target providers (18) and written patient educational materials (19) do not use the phrase "weak or failing kidneys". Most high-quality educational materials use the phrase "chronic kidney disease" and "protein in the urine" or "albumin in the urine" to introduce to patients the two different laboratory abnormalities that define CKD.…”

Health literacy in kidney disease: Review of the literature and implications for clinical practice

“…org/toolkit. Additional resources include an online plain language medical dictionary (www.lib.umich.edu/plain- recently published reviews of the readability of patient education materials in chronic kidney disease are also available [34,35] .…”

Self-Management Program for People with Chronic Kidney Disease in Vietnam: A Pragmatic Randomised Controlled Trial

“…First, the use of the Vietnamese language CKD booklet and a handout that summarised the intervention topics during the face-to-face educational sessions would provide valuable information about kidney disease, which was necessary to improve participants' knowledge. Second, the CKD booklet was translated and adapted produced by a kidney disease advocacy group and was one of the top five CKD patient education materials (Tuot, Davis, Velasquez, Banerjee, & Powe, 2013). However, a Vietnamese language version which had been contextualised for Vietnam was not available, so this study developed this resource.…”