CKD Knowledge and CKD Report Card Use During a Nephrology Encounter: A Randomized Trial

Abstract

Rationale & Objective

Higher chronic kidney disease (CKD) knowledge and health literacy (HL) are associated with improved CKD outcomes. We sought to determine if the CKD Report Card intervention increased CKD knowledge in patients regardless of HL level.

Study Design

A block-randomized trial by clinic session.

Setting & Participants

Patients with CKD 3 or above in an urban academic nephrology clinic.

Intervention

The intervention group received the CKD Report Card, a 2-sided information sheet, before the clinic visit.

Outcomes

Kidney Knowledge Survey pre–post-visit score change.

Results

Of 91 participants, the average age was 66.2 years, 64.8% identified as African American, 41.8% were male, and 11.0% had inadequate HL. The control group’s (n = 53) mean pre-visit knowledge score was 55.8% with a post–pre-score change of 0.9 (95% confidence intervals [CI], −1.3 to 3.2). The intervention group’s (n = 38) mean pre-visit score was 60.2% with a score change of 19.2 (95% CI, 15.2-23.3). The difference in score change between the control group and intervention group was −18.4 (95% CI, −22.6 to −14.1). In addition, there was no significant difference in knowledge gained by adequate and inadequate HL for the control group (P = 0.6) or the intervention group (P = 0.6). In the fully adjusted multivariable model, the HL × group interaction term was not significant (β = −6.1; P = 0.4). Pre-visit score (β = −0.2; P < 0.01) and intervention group (β = 19.0; P < 0.001) were significant.

Limitations

Limited generalizability because the study took place at 1 academic medical center and there were only a small proportion of patients with inadequate HL.

Conclusions

The CKD Report Card is a low-touch, low-cost intervention that improved CKD knowledge for all patients in our urban nephrology clinic regardless of HL level.