Quality improvement intervention boosted education in patients with kidney disease
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Key takeaways:
- The percentage of patients who received modality education increased from 27.1% to 56.7%.
- The rate of choosing home dialysis stayed the same at 50.9%.
A quality improvement intervention successfully boosted education among patients with kidney disease but did not achieve higher home dialysis choice rates, according to study results.
“Evidence from systematic reviews suggests an association between early pre-dialysis education and improved patient outcomes, particularly highlighting that delays in education are linked to higher mortality rates in the first year of dialysis,” Shiyu Lu, MD, of the nephrology division at University of Toronto in Canada, wrote with colleagues.
Lu and colleagues initiated a new referral protocol in September 2022 that directed patients with advanced kidney disease to receive modality education sessions. Overall, 532 patients across 1,723 clinical interactions at Sunnybrook Health Sciences Centre in Toronto, Canada, where observed from October 2019 to June 2023. The protocol specifically required nephrologists to refer patients with an eGFR below 15 mL/min/1.73 m2 or specified Kidney Failure Risk Equation scores to modality educators for learning intervention.
“Individualized educational programs are essential, aiming to address the diverse needs across patient populations, thereby ensuring that more individuals can benefit from the improved autonomy and quality of life afforded by home dialysis,” the researchers wrote.
The primary outcome was the selection of home dialysis following modality education.
The percentage of patients who received modality education increased from 27.1% to 56.7% with the updated referral system, researchers found. The rate of choosing home dialysis stayed the same at 50.9%. Overall home dialysis prevalence at Sunnybrook averaged 19.6%, Lu and colleagues found, which was lower than the provincial average of 24.4% after the study.
While quality improvement interventions may effectively enhance modality education rates, it is “critical to acknowledge that elevated educational engagement does not directly result in an increased selection of home dialysis options by patients,” the researchers wrote. “It is imperative that future research delves into the complex interplay between educational content, the timing of its delivery, and patient decision-making.”
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