Facilitating Anemia Treatment Risk Communication for Patients with Kidney Disease

描述（由申请人提供）：患者教育是慢性肾脏病（CKD）护理中患者和提供者的优先事项和期望。然而，即使在与卫生保健提供者频繁互动的情况下，患者也经常报告对慢性疾病（如糖尿病，心脏病和肾脏疾病）的了解不足。 这表明患者和供应商之间的沟通无效。 最近，已描述了红细胞生成刺激剂（ESA）的潜在风险，FDA已强制要求确保患者知情参与该治疗，作为风险评估和缓解策略（REMS）的一部分。风险信息对许多患者来说仍然是一个复杂的概念。在患有肾脏疾病并接受ESA治疗的患者中，贫血知识往往较差。 一种解释可能是，提供者几乎没有资源来促进对这一复杂的护理问题的有效讨论。本申请的目的是：（1）描述国家肾脏病学家样本中有关肾脏疾病贫血管理咨询的当前实践、偏好和障碍;（2）开发并检查有效工具的可行性，以促进提供者-患者沟通，提高患者贫血知识和治疗满意度。这些目标与母K23应用程序的目标一致，即确定肾脏疾病患者高效和有效健康沟通的障碍。该申请通过将这一重要的研究领域从终末期肾病（ESRD）扩展到与未接受透析的晚期慢性肾病患者相关的护理组成部分，进一步推进了母公司奖项的总体目标。拟议的教育干预措施将专门设计用于允许移植到各种护理环境--包括那些弱势患者群体，例如健康素养较低的患者群体。此外，根据提案的目标，本研究将进一步扩大P.I.的经验和专业知识。大型国家调查设计、管理和分析。这将进一步推进P.I.建立一个独立的研究生涯。

DESCRIPTION (provided by applicant): Patient education is a priority and desired by both patients and providers in the care of chronic kidney disease (CKD). Yet, even in the setting of frequent interactions with health care providers, patients often report low knowledge of chronic diseases, such as diabetes, heart disease, and kidney disease. This suggests ineffective communication between patients and providers. Recently, the potential risks of erythropoiesis stimulating agents (ESAs) have been described and the FDA has mandated ensuring patients are informed participants in this treatment as part of a Risk Evaluation and Mitigation Strategy (REMS). Risk information remains a complex concept for many patients. In patients with kidney disease and receiving ESAs anemia knowledge is often poor. One explanation may be that there are few resources available to providers to promote effective discussions about this complex care issue. The objectives of this application are to: (1) characterize the current practice, preferences, and barrier to counseling about anemia management in kidney disease among a national sample of nephrologists; and (2) to develop and examine the feasibility of an efficient tool to facilitate provider-patient communication to improve patient anemia knowledge and treatment satisfaction. These objectives are in concert with the parent K23 application's goal to determine barriers to efficient and effective health communication for patients with kidney disease. This application furthers the overall goal of the parent award by extending this important area of investigation from end-stage renal disease (ESRD) to a component of care relevant to patients with advanced chronic kidney disease not receiving dialysis. The proposed educational intervention will be designed specifically to permit transplantation to a variety of care settings - including those with vulnerable patient populations, such as those with low health literacy. Additionally, in accordance with the goals of the proposal, this study will further expand the experience and expertise of the P.I. in large national survey design, administration and analyses. This will further advance the pathway of the P.I. to establishing an independent research career.