Facilitating Anemia Treatment Risk Communication for Patients with Kidney Disease

描述(由申请人提供)：在慢性肾脏疾病(CKD)的护理中，患者教育是患者和提供者所希望的优先事项。然而，即使在与医疗保健提供者频繁互动的背景下，患者报告的慢性病知识往往也很低，如糖尿病、心脏病和肾脏疾病。这表明患者和提供者之间的沟通不力。最近，红细胞生成刺激剂(ESA)的潜在风险已被描述，FDA已强制确保患者知情参与这种治疗，作为风险评估和缓解策略(REMS)的一部分。对于许多患者来说，风险信息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，贫血知识往往很差。一种解释可能是，提供者几乎没有可用的资源来促进关于这一复杂护理问题的有效讨论。该应用程序的目标是：(1)在全国肾脏病专家样本中描述目前肾脏疾病贫血管理咨询的做法、偏好和障碍；以及(2)开发和研究一种有效工具的可行性，以促进提供者和患者之间的沟通，以提高患者对贫血的知识和治疗满意度。这些目标与家长K23应用程序的目标一致，即为肾病患者确定有效和有效的健康沟通障碍。这一应用通过将这一重要的研究领域从终末期肾脏疾病(ESRD)扩展到与未接受透析的晚期慢性肾脏疾病患者相关的护理组成部分，进一步推动了家长奖的总体目标。拟议的教育干预措施将专门设计，以允许移植到各种护理环境--包括那些易受伤害的患者群体，例如那些健康素养较低的人。此外，根据该提案的目标，这项研究将进一步扩大P.I.在大型国家调查设计、管理和分析方面的经验和专门知识。这将进一步推进P.I.建立独立研究事业的道路。

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.