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CKD Knowledge and CKD Report Card Use During a Nephrology Encounter: A Randomized Trial
Jillian Bowman1, Christina Zhou2, Lindsay Zasadzinski3
1Pritzker School of Medicine, University of Chicago Medicine, Chicago, IL.
Insights
The CKD Report Card intervention significantly improved chronic kidney disease (CKD) knowledge in patients. This low-cost educational tool enhanced understanding for all participants, irrespective of their health literacy (HL) levels.
Area of Science:
- Nephrology
- Health Education
- Patient Outcomes
Background:
- Higher chronic kidney disease (CKD) knowledge and health literacy (HL) are linked to better patient outcomes.
- Understanding the impact of educational interventions on CKD knowledge is crucial for improving patient care.
Purpose of the Study:
- To assess if the CKD Report Card intervention effectively increased CKD knowledge among patients.
- To determine if the intervention's effectiveness varied based on patients' health literacy levels.
Main Methods:
- A block-randomized trial was conducted in an urban academic nephrology clinic.
- Patients with CKD stage 3 or above received either the CKD Report Card (intervention) or standard care (control) before their visit.
- Kidney Knowledge Survey scores were measured pre- and post-visit to determine knowledge change.
Main Results:
- The intervention group showed a significant increase in CKD knowledge (19.2 points) compared to the control group (0.9 points).
- The CKD Report Card intervention led to a greater difference in score change (-18.4 points) compared to the control group.
- No significant difference in knowledge gain was observed between patients with adequate and inadequate health literacy in either group.
Conclusions:
- The CKD Report Card is an effective, low-cost intervention for enhancing CKD knowledge.
- The intervention improved CKD knowledge for all patients, regardless of their health literacy level.
- The study highlights the potential of simple educational tools in managing chronic kidney disease.
Rationale & Objective:
Higher chronic kidney disease (CKD) knowledge and health literacy (HL) are associated with improved CKD outcomes. We sought to determine if the CKD Report Card intervention increased CKD knowledge in patients regardless of HL level.
Study Design:
A block-randomized trial by clinic session.
Setting & Participants:
Patients with CKD 3 or above in an urban academic nephrology clinic.
Intervention:
The intervention group received the CKD Report Card, a 2-sided information sheet, before the clinic visit.
Outcomes:
Kidney Knowledge Survey pre-post-visit score change.
Results:
Of 91 participants, the average age was 66.2 years, 64.8% identified as African American, 41.8% were male, and 11.0% had inadequate HL. The control group's (n = 53) mean pre-visit knowledge score was 55.8% with a post-pre-score change of 0.9 (95% confidence intervals [CI], -1.3 to 3.2). The intervention group's (n = 38) mean pre-visit score was 60.2% with a score change of 19.2 (95% CI, 15.2-23.3). The difference in score change between the control group and intervention group was -18.4 (95% CI, -22.6 to -14.1). In addition, there was no significant difference in knowledge gained by adequate and inadequate HL for the control group (P = 0.6) or the intervention group (P = 0.6). In the fully adjusted multivariable model, the HL × group interaction term was not significant (β = -6.1; P = 0.4). Pre-visit score (β = -0.2; P < 0.01) and intervention group (β = 19.0; P < 0.001) were significant.
Limitations:
Limited generalizability because the study took place at 1 academic medical center and there were only a small proportion of patients with inadequate HL.
Conclusions:
The CKD Report Card is a low-touch, low-cost intervention that improved CKD knowledge for all patients in our urban nephrology clinic regardless of HL level.
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