Role of telehealth in renal replacement therapy education

Abstract

The prevalence of end-stage renal disease is rising in the United States, which bears high financial and public health burden. The most common modality of renal replacement therapy (RRT) in the United States is in-center hemodialysis. Many patients report lack of comprehensive and timely education about their treatment options, which may preclude them from participating in home-based dialysis therapies and kidney transplantation evaluation. While RRT education has traditionally been provided in-person, the rise of telehealth has afforded new opportunities to improve upon the status quo. For example, technology-augmented RRT education has recently been implemented into telehealth nephrology clinics, informational websites and mobile applications maintained by professional organizations, patient-driven forums on social media, and multimodality programs. The benefits of technology in RRT education are increased access for geographically isolated and/or medically frail patients, versatility of content delivery, information repetition to enhance knowledge retention, and interpersonal connection for educational content and emotional support. Challenges center around privacy and accuracy of information sharing, in addition to differential access to technology due to age and socioeconomic status. A review of available scholarly and social media resources suggests that technology-aided delivery of education about treatment options for end-stage renal disease provides an important alternative and/or supplemental resource for patients and families.

The need for renovating patient education in kidney transplantation: A qualitative study

“…Studies have shown that using remote technology-based education such as websites, smartphone applications, and social networks as a strategy has increased knowledge, medication adherence, and patient education effectiveness in transplanted recipients. [ 37 38 39 ] From the participants' point of view, teamwork patient education was one of the key elements of patient education. This is consistent with the study of Farahani et al ., in which lack of collaboration and coordination between health-care providers in health education was identified as a problem by the participants.…”

Management of Advanced Chronic Kidney Disease During the COVID-19 Pandemic: Suggestions From the Canadian Society of Nephrology COVID-19 Rapid Response Team

“…Compared with in-person KRT education, content delivered using telehealth has the benefits of being flexible, adaptable to patient learning styles/preferences, and easily amenable to repetition and reinforcement. 10 Potential resources are outlined below: Reinforcing education around uremia may reduce the risk of clinical deterioration at home and subsequent "crash starts," hospitalizations and other adverse outcomes, which have been experienced in some European centers (personal communication Markus van der Giet). Educational material on sick-day rules (suggested medication changes on days when the patient is unwell enough to do their usual activities) may help to avoid preventable acute kidney injury (AKI) and other adverse outcomes that may result in avoidable contact with the healthcare system.…”

“…Compared with in-person KRT education, content delivered using telehealth has the benefits of being flexible, adaptable to patient learning styles/preferences, and easily amenable to repetition and reinforcement. 10 Potential resources are outlined below:…”

Asistencia y educación en nefrología en épocas de COVID-19: transformando amenazas en oportunidades

“…Entre las más relevantes destacan aquellas dirigidas al control clínico a distancia de pacientes con enfermedad renal crónica [3][4][5] , interconsulta al nefrólogo desde el primer nivel de atención 6,7 , control periódico de pacientes incluidos en programas de diálisis peritoneal [8][9][10][11][12] , manejo protocolizado de complicaciones de la diálisis peritoneal 13 , control de hemodiálisis (HD) domiciliaria y reclutamiento de pacientes para las listas de trasplante renal 5 , entre otras. Además de estas estrategias asistenciales directas, se han desarrollado programas dirigidos a potenciar la asistencia nefrológica interdisciplinaria 14,15 , educar a grupos de pacientes en el conocimiento y manejo de opciones de terapia de reemplazo renal (TRR) y optimizar las estrategias de autocuidado de pacientes en TRR 16,17 . Algunas de estas estrategias se ven auxiliadas por dispositivos de telemedicina que permiten monitorizar a distancia y en forma automática parámetros objetivos, como peso, presión arterial, temperatura, saturación de oxígeno e, incluso, la diálisis domiciliaria y el diagnóstico mediante telepatología 5 .…”