title: A question prompt sheet for adult patients with chronic kidney disease.
abstract: Patients with chronic kidney disease (CKD) commonly have unmet information needs. Greater patient participation in healthcare discussions can address these needs and improve health outcomes. We developed a patient-centered question prompt sheet (QPS) to engage CKD patients in healthcare conversations.
  
  
  
  We conducted a two phase, mixed-methods, cross-sectional study involving semi-structured telephone interviews. Patients with an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2, on dialysis, or with a kidney transplant were recruited from one Veterans Affairs (VA) nephrology clinic. Phase 1 interviews included open-ended questions assessing patients' CKD-related information needs and generated a preliminary 67-item QPS. Phase 2 interview participants rated the importance of asking each question on a 5-point Likert scale and provided open-ended feedback. All participants rated their willingness to use a CKD-QPS. Input from patient ratings, a multidisciplinary team, and from members of the National Kidney Disease Education Program (NKDEP) Coordinating Panel helped to shorten and refine the QPS. A qualitative thematic approach was used to analyze open-ended responses. Quantitative data were analyzed for means and proportions.
  
  
  
  Eighty-five patients participated. Most were male (97 %), non-Hispanic white (71 %), and mean age was 67 years. Patients desired more information about CKD, particularly dialysis/transplant, and the relationship between CKD and comorbid medical conditions. The final QPS included 31-questions divided into 7 CKD subtopics. Most patients (88 %) reported being 'completely' or 'very' willing to use a CKD-QPS in future doctor visits.
  
  
  
  CKD patients have unmet information needs. We developed a QPS to engage CKD patients in healthcare discussions and to facilitate patient-centered care. Future research should assess whether the CKD-QPS addresses patients' information needs, enhances doctor-patient communication, and improves health outcomes.
authors.affiliation: Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, USA.|Jesse Brown VA Medical Center, Chicago, IL, USA.|Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USA.
authors.forename: Swati
authors.initials: S
authors.lastname: Lederer
authors.affiliation: Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, USA.|Jesse Brown VA Medical Center, Chicago, IL, USA.|Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fischer
authors.affiliation: Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, USA.|Jesse Brown VA Medical Center, Chicago, IL, USA.|Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USA.
authors.forename: Howard S
authors.initials: HS
authors.lastname: Gordon
authors.affiliation: Department of Medicine, Edward Hines Jr. VA Hospital, Hines, IL, USA.|Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Anuradha
authors.initials: A
authors.lastname: Wadhwa
authors.affiliation: Department of Medicine, Edward Hines Jr. VA Hospital, Hines, IL, USA.|Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Subhash
authors.initials: S
authors.lastname: Popli
authors.affiliation: Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, USA. e-gordon@northwestern.edu.|Center for Healthcare Studies, and Department of Surgery, Division of Transplantation, Northwestern University Feinberg School of Medicine, 633 N. St. Clair, 20th Floor, Chicago, IL, 60611, USA. e-gordon@northwestern.edu.
authors.forename: Elisa J
authors.initials: EJ
authors.lastname: Gordon
mesh_terms: D000368:Aged; D057189:Checklist; D003142:Communication; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000628:therapy*
keywords: Kidney disease; Patient-centered care; Shared-decision making