Pilot Study of a Physician-Delivered Education Tool to Increase Patient Knowledge About CKD
Pilot Study of a Physician-Delivered Education Tool to Increase Patient Knowledge About CKD
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DOI：
10.1053/j.ajkd.2013.01.023
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发表时间：
2013-07-01
影响因子：
13.2
通讯作者：
Cavanaugh, Kerri L.
中科院分区：
文献类型：
--
作者：
Nunes, Julie Wright;Greene, Jane H.;Cavanaugh, Kerri L.
背景：关于医生提供的教育干预的研究有限。我们研究了一种教育工具在促进医患肾脏疾病交流方面的可行性和影响。研究设计：具有历史对照的试点可行性临床试验，以检验对患者知识的影响大小，并提出结构化问题以获得医生和患者的反馈。环境和参与者：成人慢性肾脏疾病（CKD） 1-5期，见肾内科门诊。干预：1页教育工作表，由医生和患者共同审阅。结果：患者组之间的肾脏知识和提供者/患者反馈。测量方法：使用先前有效的问卷测量患者肾脏知识，比较接受干预的患者（2010年4月至10月）和历史队列（2009年4月至10月）。提供者的输入是通过结构化访谈获得的。患者输入通过调查问题获得。从病历中提取患者特征。结果：纳入556例患者，其中401例患者为历史队列，155例患者接受干预。平均年龄为57±16 （SD）岁，男性53%，白人81%，CKD 3-5期78%。与历史队列相比，接受干预的患者知道自己患有CKD（校正OR， 2.20; 95% CI, 1.16-4.17; P = 0.02）、知道自己的肾功能（校正OR， 2.25; 95% CI, 1.27-3.97; P = 0.005）、知道自己的CKD分期（校正OR， 3.22; 95% CI, 1.49-6.92; P = 0.003）的调整几率更高。医生发现该干预工具易于应用于实践，98%接受干预的患者推荐将来使用。局限性：研究设计没有随机分配患者进行比较，入组是在一个中心的诊所进行的。结论：在这项初步研究中，医生提供的教育干预在实践中是可行的，并且与更高的患者肾脏疾病知识相关。应该通过随机试验进一步检查医生提供的教育干预措施，以提高患者对疾病的了解。[J]中华肾脏病杂志，2016(1):23-32。(C) 2013年由国家肾脏基金会，Inc。
Background: Limited research exists on physician-delivered education interventions. We examined the feasibility and impact of an educational tool on facilitating physician-patient kidney disease communication.Study Design: Pilot feasibility clinical trial with a historical control to examine effect size on patient knowledge and structured questions to elicit physician and patient feedback.Setting & Participants: Adults with chronic kidney disease (CKD) stages 1-5, seen in nephrology clinic.Intervention: 1-page educational worksheet, reviewed by physicians with patients.Outcomes: Kidney knowledge between patient groups and provider/patient feedback.Measurements: Patient kidney knowledge was measured using a previously validated questionnaire compared between patients receiving the intervention (April to October 2010) and a historical cohort (April to October 2009). Provider input was obtained using structured interviews. Patient input was obtained through survey questions. Patient characteristics were abstracted from the medical record.Results: 556 patients were included, with 401 patients in the historical cohort and 155 receiving the intervention. Mean age was 57 +/- 16 (SD) years, with 53% men, 81% whites, and 78% with CKD stages 3-5. Compared with the historical cohort, patients receiving the intervention had higher adjusted odds of knowing they had CKD (adjusted OR, 2.20; 95% CI, 1.16-4.17; P = 0.02), knowing their kidney function (adjusted OR, 2.25; 95% CI, 1.27-3.97; P = 0.005), and knowing their stage of CKD (adjusted OR, 3.22; 95% CI, 1.49-6.92; P = 0.003). Physicians found the intervention tool easy and feasible to integrate into practice and 98% of patients who received the intervention recommended it for future use.Limitations: Study design did not randomly assign patients for comparison and enrollment was performed in clinics at one center.Conclusions: In this pilot study, a physician-delivered education intervention was feasible to use in practice and was associated with higher patient kidney disease knowledge. Further examination of physician-delivered education interventions for increasing patient disease understanding should be tested through randomized trials. Am J Kidney Dis.62(1): 23-32. (C) 2013 by the National Kidney Foundation, Inc.