title: Educating Patients about CKD: The Path to Self-Management and Patient-Centered Care.
abstract: Patient education is associated with better patient outcomes and supported by international guidelines and organizations, but a range of barriers prevent widespread implementation of comprehensive education for people with progressive kidney disease, especially in the United States. Among United States patients, obstacles to education include the complex nature of kidney disease information, low baseline awareness, limited health literacy and numeracy, limited availability of CKD information, and lack of readiness to learn. For providers, lack of time and clinical confidence combine with competing education priorities and confusion about diagnosing CKD to limit educational efforts. At the system level, lack of provider incentives, limited availability of practical decision support tools, and lack of established interdisciplinary care models inhibit patient education. Despite these barriers, innovative education approaches for people with CKD exist, including self-management support, shared decision making, use of digital media, and engaging families and communities. Education efficiency may be increased by focusing on people with progressive disease, establishing interdisciplinary care management including community health workers, and providing education in group settings. New educational approaches are being developed through research and quality improvement efforts, but challenges to evaluating public awareness and patient education programs inhibit identification of successful strategies for broader implementation. However, growing interest in improving patient-centered outcomes may provide new approaches to effective education of people with CKD.
authors.affiliation: Division of Kidney, Urologic, and Hematologic Diseases, National Kidney Disease Education Program, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland; and narvaa@niddk.nih.gov.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Narva
authors.affiliation: Division of Kidney, Urologic, and Hematologic Diseases, National Kidney Disease Education Program, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland; and.
authors.forename: Jenna M
authors.initials: JM
authors.lastname: Norton
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina.
authors.forename: L Ebony
authors.initials: LE
authors.lastname: Boulware
mesh_terms: D006801:Humans; D010353:Patient Education as Topic; D018802:Patient-Centered Care; D051436:Renal Insufficiency, Chronic / Q000628:therapy*; D012648:Self Care; D014481:United States
keywords: chronic kidney disease; decision making; health literacy; humans; kidney diseases; learning; patient centered care; patient education; self-management; shared decision making