Educating Patients about CKD

Abstract

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.

The next generation of therapeutics for chronic kidney disease

“…The specific factors contributing to this gap are complex, but certainly 7,9 include lack of patient disease awareness and self-advocacy 247 . Research has shown that disease awareness in patients with CKD stages 1–3 is as low as 5% even in patients that have seen a physician within the last year 247–250 . Physicians may neglect mentioning to patients the fact that they have kidney disease, perhaps in part because they don’t believe they can offer effective therapeutic options.…”

Utilization of peritoneal dialysis in the United States: Reasons for underutilization, specifically in New York State and the boroughs of New York City

“…In addition, there may be no reliable partner for home‐based therapies . Patient‐related factors may include much comorbidity, belief they would be better off in a hospital, fear of self‐cannulation (in home hemodialysis), limited health literacy, and as many patients do not have consistent predialysis care by a nephrologist, lack of awareness about home‐based therapies . It is with these patient‐related factors that public health strategies within a community may be of benefit.…”

Kidney health for everyone, everywhere: from prevention to detection and equitable access to care

“…34 In Cuba, the Ministry of Public Health has implemented a national programme for the prevention of CKD. Narva et al 43 found that patient education is associated with better patient outcomes. There has been an increased rate of the diagnosis of diabetes and of glycaemic control, as well as an increased diagnosis of patients with hypertension, higher prescription use of renoprotective treatment with angiotensin converting enzyme inhibitor and higher rates of blood pressure control.…”