VA’s CKD Patients Lack Knowledge About Their Condition

by U.S. Medicine

November 5, 2015

CHICAGO — Chronic kidney disease (CKD) patients at the VA have insufficient knowledge about their condition, which is associated with poorer health outcomes, according to a recent study.

The report, published in the Clinical Kidney Journal, suggests that effective patient-provider communication can improve CKD patients’ knowledge and improve their participation in effective self-care.1

The study team, led by researchers from the Jesse Brown VAMC in Chicago, the Edward Hines Jr. VA Hospital in Hines, IL, and the University of Illinois at Chicago College of Medicine, notes, however, that barriers to addressing CKD patients’ information needs had not been characterized prior to this study.

For the study, researchers recruited veterans with an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2 or on chronic dialysis or with a kidney transplant from a VA nephrology clinic. They then conducted semi-structured telephone interviews to assess patients’ CKD information needs and demographic characteristics with 32 participants, mostly male and non-Hispanic white, who averaged 63 years old.

CKD severity groups represented included CKD-3 (eGFR 30–59 mL/min/1.73 m2; 34%), CKD-4 (eGFR 15–29 mL/min/1.73 m2; 25%), CKD-5 (eGFR <15 mL/min/1.73 m2; 16%), end-stage kidney disease on dialysis (13%) and kidney transplant recipients (12%).

“Several key themes emerged about barriers to patient–provider communication based on patients’ reported care at both VA and non-VA facilities, including patients perceived their role as a ‘listener,’ reported limited CKD knowledge, did not understand physicians’ explanations and were dissatisfied with the patient-provider relationship,” study authors noted.

They called for future research to evaluate whether interventions that empower CKD patients to actively participate in their care increase knowledge and improve health outcomes.

1 Lederer S, Fischer MJ, Gordon HS, Wadhwa A, Popli S, Gordon EJ. Barriers to effective communication between veterans with chronic kidney disease and their healthcare providers. Clin Kidney J (2015) doi: 10.1093/ckj/sfv079 First published online: September 3, 2015


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