Directed Use of the Internet for Health Information by Patients With Chronic Kidney Disease: Prospective Cohort Study

Diamantidis, Clarissa J.; Fink, Wanda; Yang, Shiming; Zuckerman, Marni; Ginsberg, Jennifer S.; Hu, Peter; Xiao, Yingfeng; Fink, Jeffrey C.

doi:10.2196/jmir.2848

Cited by 41 publications

(42 citation statements)

References 15 publications

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“…Because portal use may itself serve as a marker of patient engagement, additional studies are needed to confirm our findings and to explore other potential health benefits in a nephrology setting. For example, portals can be modified to include CKD educational information (17,75), medication safety checks in the setting of impaired renal function (76), dietary guidance (77), and checklists and reminders regarding kidney transplant evaluation (17). Randomized controlled trials are needed to overcome potential confounding due to patient-level variables (e.g., health literacy, patient activation) that we could not discern.…”

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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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

View full text Add to dashboard Cite

show abstract

“…These trends seem to hold for individuals with and at risk for CKD. An evaluation of a website providing safety information to patients with CKD suggests that patients are interested in accessing CKD information online (83). Among patients with transplants, interest in receiving CKD education and SMS through mobile health has been confirmed through focus groups (84) and surveys (85), and a mobile health intervention improved medication adherence and BP control (86).…”

Section: Innovative Approaches To Ckd Educationmentioning

confidence: 99%

Educating Patients about CKD

Narva

Norton

Boulware

2016

Clinical Journal of the American Society of Nephrology

197

190

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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.

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“…In one study of 108 CKD patients, only 28.7% visited an informational website about CKD safety after personal instruction on how to access the website. 36 Reasons for the low participation rate were not clear. Diamantidis and colleagues tested a medical inquiry system to guide the safe use of medications.…”

Section: Matching the Health Information Technology To The Usermentioning

confidence: 99%

Telemedicine to Promote Patient Safety: Use of Phone-Based Interactive Voice-Response System to Reduce Adverse Safety Events in Pre-dialysis CKD

Weiner

Fink

2017

Advances in Chronic Kidney Disease

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Chronic kidney disease (CKD) patients have several features conferring upon them a high risk of adverse safety events, which are defined as incidents with unintended harm related to processes of care or medications. These characteristics include impaired renal function, polypharmacy, and frequent health system encounters. The consequences of such events in CKD can include new or prolonged hospitalization, accelerated renal function loss, acute kidney injury, end-stage renal disease and death. Health information technology administered via telemedicine presents opportunities for CKD patients to remotely communicate safety-related findings to providers for the purpose of improving their care. However, many CKD patients have limitations which hinder their use of telemedicine and access to the broad capabilities of health information technology. In this review we summarize previous assessments of the pre-dialysis CKD populations’ proficiency in using telemedicine modalities and describe the use of interactive voice-response system (IVRS) to gauge the safety phenotype of the CKD patient. We discuss the potential for expanded IVRS use in CKD to address the safety threats inherent to this population.

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Directed Use of the Internet for Health Information by Patients With Chronic Kidney Disease: Prospective Cohort Study

Cited by 41 publications

References 15 publications

Disparities in Electronic Health Record Patient Portal Use in Nephrology Clinics

Disparities in Electronic Health Record Patient Portal Use in Nephrology Clinics

Educating Patients about CKD

Telemedicine to Promote Patient Safety: Use of Phone-Based Interactive Voice-Response System to Reduce Adverse Safety Events in Pre-dialysis CKD

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