Nicola Thomas PhD, Catriona Ewart MA, Carolyn Hill MSc
{"title":"评估利用智能手机技术进行白蛋白-肌酐比值家庭尿液分析的可行性和可接受性：质量改进项目。","authors":"Nicola Thomas PhD, Catriona Ewart MA, Carolyn Hill MSc","doi":"10.1111/jorc.12460","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Despite albumin-creatinine ratio (urine) testing being recommended for detection of chronic kidney disease among adults with diabetes, testing rates are suboptimal.</p>\n </section>\n \n <section>\n \n <h3> Aim</h3>\n \n <p>We implemented and evaluated a quality improvement project in an inner-city diabetes population in London, UK to assess the feasibility and acceptability of implementing novel home-based urinalysis using smartphone technology.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>After eligible patients were identified and consented, testing kits were sent to the patient's home. Test results and patient feedback were collected through the smartphone application. Focus group discussions were conducted to evaluate primary care staff perspectives on uptake and delivery of the service.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>In total 2370 patients agreed to take part. Of these, 1244 completed the test (61% of those eligible) and of these, 465 (37%) had clinically significant albuminuria. 98% of patients found the test easy or very easy to use. Staff in primary care found the service to be beneficial for patients, and reported ease of set up and minimal administrative processes. Concerns regarding barriers among patients with lower digital literacy and non-English speakers were raised although these concerns were not substantiated.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Home-based albumin-creatinine ratio urine testing may improve the testing rates of people with diabetes at higher risk of chronic kidney disease. This is important post-pandemic, as healthcare services are trying to return to pre-pandemic levels of care. The study also found that the use of smartphone technology in an underserved (deprived) community is feasible, despite reservations about levels of digital literacy and possible language barriers. Further evaluation of effectiveness and costs is required.</p>\n </section>\n </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"50 2","pages":"104-111"},"PeriodicalIF":1.5000,"publicationDate":"2023-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.12460","citationCount":"0","resultStr":"{\"title\":\"Evaluating the feasibility and acceptability of home-based urinalysis for albumin-creatinine ratio with smartphone technology: A quality improvement project\",\"authors\":\"Nicola Thomas PhD, Catriona Ewart MA, Carolyn Hill MSc\",\"doi\":\"10.1111/jorc.12460\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Despite albumin-creatinine ratio (urine) testing being recommended for detection of chronic kidney disease among adults with diabetes, testing rates are suboptimal.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>We implemented and evaluated a quality improvement project in an inner-city diabetes population in London, UK to assess the feasibility and acceptability of implementing novel home-based urinalysis using smartphone technology.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>After eligible patients were identified and consented, testing kits were sent to the patient's home. Test results and patient feedback were collected through the smartphone application. Focus group discussions were conducted to evaluate primary care staff perspectives on uptake and delivery of the service.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>In total 2370 patients agreed to take part. Of these, 1244 completed the test (61% of those eligible) and of these, 465 (37%) had clinically significant albuminuria. 98% of patients found the test easy or very easy to use. Staff in primary care found the service to be beneficial for patients, and reported ease of set up and minimal administrative processes. Concerns regarding barriers among patients with lower digital literacy and non-English speakers were raised although these concerns were not substantiated.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Home-based albumin-creatinine ratio urine testing may improve the testing rates of people with diabetes at higher risk of chronic kidney disease. This is important post-pandemic, as healthcare services are trying to return to pre-pandemic levels of care. The study also found that the use of smartphone technology in an underserved (deprived) community is feasible, despite reservations about levels of digital literacy and possible language barriers. 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Evaluating the feasibility and acceptability of home-based urinalysis for albumin-creatinine ratio with smartphone technology: A quality improvement project
Background
Despite albumin-creatinine ratio (urine) testing being recommended for detection of chronic kidney disease among adults with diabetes, testing rates are suboptimal.
Aim
We implemented and evaluated a quality improvement project in an inner-city diabetes population in London, UK to assess the feasibility and acceptability of implementing novel home-based urinalysis using smartphone technology.
Methods
After eligible patients were identified and consented, testing kits were sent to the patient's home. Test results and patient feedback were collected through the smartphone application. Focus group discussions were conducted to evaluate primary care staff perspectives on uptake and delivery of the service.
Results
In total 2370 patients agreed to take part. Of these, 1244 completed the test (61% of those eligible) and of these, 465 (37%) had clinically significant albuminuria. 98% of patients found the test easy or very easy to use. Staff in primary care found the service to be beneficial for patients, and reported ease of set up and minimal administrative processes. Concerns regarding barriers among patients with lower digital literacy and non-English speakers were raised although these concerns were not substantiated.
Conclusion
Home-based albumin-creatinine ratio urine testing may improve the testing rates of people with diabetes at higher risk of chronic kidney disease. This is important post-pandemic, as healthcare services are trying to return to pre-pandemic levels of care. The study also found that the use of smartphone technology in an underserved (deprived) community is feasible, despite reservations about levels of digital literacy and possible language barriers. Further evaluation of effectiveness and costs is required.
期刊介绍：
The Journal of Renal Care (JORC), formally EDTNA/ERCA Journal, is the official publication of the European Dialysis and Transplant Nursing Association/European Renal Care Association (EDTNA/ERCA).
The Journal of Renal Care is an international peer-reviewed journal for the multi-professional health care team caring for people with kidney disease and those who research this specialised area of health care. Kidney disease is a chronic illness with four basic treatments: haemodialysis, peritoneal dialysis conservative management and transplantation, which includes emptive transplantation, living donor & cadavaric transplantation. The continuous world-wide increase of people with chronic kidney disease (CKD) means that research and shared knowledge into the causes and treatment is vital to delay the progression of CKD and to improve treatments and the care given.
The Journal of Renal Care is an important journal for all health-care professionals working in this and associated conditions, such as diabetes and cardio-vascular disease amongst others. It covers the trajectory of the disease from the first diagnosis to palliative care and includes acute renal injury. The Journal of Renal Care accepts that kidney disease affects not only the patients but also their families and significant others and provides a forum for both the psycho-social and physiological aspects of the disease.
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