Pre-visit handout raised post-visit CKD knowledge regardless of health literacy
Key takeaways:
- Patients with CKD who received an education handout before a nephrology visit had a 19 percentage point increase in knowledge post-visit.
- Results were similar for patients with inadequate health literacy.
Adults with chronic kidney disease who received a short handout about CKD before seeing a nephrologist showed increased knowledge of the disease after the visit compared with patients who did not receive the educational material.
Results were similar for patients with adequate and inadequate health literacy, according to researchers.
Milda R. Saunders, MD, MPH, associate professor of medicine at the University of Chicago Medicine, and colleagues assessed the pre- and post-visit knowledge about CKD of 91 adults. Participants were randomly assigned by visit block — morning or afternoon on different days — to usual care (n = 53) or the CKD Report Card group (n = 38), who received a one-page, double-sided patient education handout, before their visit with a nephrologist.
“My prior work has shown that many patients were not aware that they had kidney disease, did not understand their CKD stage, and did not know why they were seeing the nephologist,” Saunders told Healio. “We started with a National Kidney Disease Education Program patient education handout and (with permission) modified it to suit our needs. The first side explains the function of the kidneys, what kidney disease is and how to prevent CKD progression. The second side contains patients’ specific information about their current blood pressure and lab values as well their goals for those.”
The mean age of the participants was 66.2 years; 59 self-identified as Black and 38 were men. All had CKD stage 3 or higher, spoke English and attended an adult nephrology clinic at an urban academic medical center from June to July 2019. Health literacy was assessed with the Brief Health Literacy Screen, and inadequate health literacy was noted for 7.5% of the usual care group and 15.8% of the intervention group. The CKD Knowledge Questionnaire, modified from the Kidney Disease Knowledge Survey, was used to assess disease-specific knowledge before and after the physician visit, and participants did not use the handout when completing the questionnaire.
The usual care group’s post-visit CKD knowledge score was not significantly changed from the pre-visit score. In contrast, the post-visit knowledge score of the intervention group increased by a statistically significant 19.2 percentage points. Results were similar for subgroups with inadequate health literacy, according to the researchers.
“We don’t know if patients [in the intervention group] were empowered to ask more questions about their CKD, if [the handout] prompted nephrologists to do more patient education, or if the handout made it easier for nephrologists to explain complicated concepts,” Saunders said. “It may have been a combination of those — different reasons for different patients.”
Saunders said more research is needed to determine ways to help patients better understand their medical conditions, particularly CKD.
“For our intervention, we want to know how we can sustain these CKD-specific knowledge gains. But most important, how can we translate increased understanding to improved patient self-management? My current work focuses on both improving patient understanding and increasing CKD self-management,” Saunders said.
For more information:
Milda R. Saunders, MD, MPH, can be reached at msaunders@uchicago.edu.
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Bowman J, et al. Kidney Med. 2025;doi:10.1016/j.xkme.2025.100991.