An education and counseling program for chronic kidney disease: strategies to improve patient knowledge

Pre-dialysis education programs assist patients in understanding their disease and treatment that may improve outcomes. We review the efficacy of our education and counseling program in improving chronic kidney disease (CKD) knowledge. Incident CKD patients not yet on renal replacement therapy (RRT) from June 2009 to February 2010 answered questionnaires developed to determine health-seeking behavior, perceived, and actual CKD knowledge. An evaluation tool was administered before and after the education modules to determine its efficacy in improving CKD knowledge. Among 299 CKD patients, 60% were males, mean age was 49 years, and 37% were high-school graduates. Primary renal disease was chronic glomerulonephritis in 30%, 60% belonged to CKD stage 5, 32.8% had no knowledge about CKD, and 43% were unaware of its severity and RRT options. CKD stage was not significantly associated with patients' perceived CKD knowledge and RRT options. Only 28% completed the modules within the 6-month follow-up period. There was a significant increase in mean scores from 7.0 +/- 5.11 to 23.0 +/- 4.5 points (P<0.00001). Patients <50 years old had significantly higher scores (P = 0.007). In a financially disadvantaged CKD population, the majority present already in CKD Stage 5. Our CKD education and counseling program was effective in improving patients' knowledge of their disease. Reasons for the non-completion of the CKD education modules sessions need to be addressed to allow more patients to benefit from the information provided.