Patient Education for Kidney Failure Treatment: A Mixed-Methods Study

Area of Science:

• Nephrology
• Medical Education
• Health Literacy

Background:

• Patients with advanced chronic kidney disease (CKD) require education on kidney failure treatment options to engage in shared decision-making (SDM).
• Current educational programs' content, accessibility, and support for SDM in CKD are not well understood.

Purpose of the Study:

• To evaluate the content, quality, and accessibility of current patient education programs for advanced CKD.
• To assess whether these programs effectively support shared decision-making (SDM).

Main Methods:

• A mixed-methods approach was used, combining qualitative observations and interviews with a quantitative content analysis of educational slide presentations.
• Data were collected from 9 education sessions, 5 educator interviews, and 133 slide presentations across four different sites.

Main Results:

• Educational materials varied widely in quality and accuracy, with a strong emphasis on dialysis and limited discussion of conservative management.
• Sessions often lacked opportunities for tailored information, failed to address key content areas (e.g., prognosis, cost, diet), and did not consistently incorporate health literacy best practices.
• Few nephrologists were involved, and patient referrals were often too late for effective education.

Conclusions:

• Current CKD patient education programs do not consistently adhere to best practices for health literacy or SDM.
• Improving patient education necessitates addressing content gaps, enhancing health literacy, and fostering better communication between educators and nephrologists.
• Integrating clear expectations for treatment options into clinical workflows is crucial for facilitating SDM.