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Acceptability of a multilevel intervention to improve blood pressure control among patients with chronic kidney disease in a public health care delivery system.
Strait, Adrienne; Velasquez, Alexandra; Handley, Margaret A; Leong, Karen; Najmabadi, Adriana; Powe, Neil R; Tuot, Delphine S.
Afiliación
  • Strait A; Division of Nephrology, University of California, San Francisco, CA, USA.
  • Velasquez A; Division of Nephrology, University of California, San Francisco, CA, USA.
  • Handley MA; Department of Medicine, University of California, San Francisco, CA, USA.
  • Leong K; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
  • Najmabadi A; Division of Nephrology, University of California, San Francisco, CA, USA.
  • Powe NR; Division of Nephrology, University of California, San Francisco, CA, USA.
  • Tuot DS; Department of Medicine, University of California, San Francisco, CA, USA.
Clin Kidney J ; 11(4): 540-548, 2018 Aug.
Article en En | MEDLINE | ID: mdl-30094019
BACKGROUND: The Kidney Awareness Registry and Education (KARE) trial examined the impact of a multilevel intervention on blood pressure control among patients with chronic kidney disease (CKD) in a public health care delivery system. KARE consisted of a clinic-based intervention (a primary care CKD registry with point-of-care provider notifications and quarterly feedback related to CKD management) and a patient-directed intervention [a CKD self-management support (CKD-SMS) program that included low literacy educational materials, automated telephone-administered self-management modules and telephone health coaching]. We explored the acceptability of these interventions among end users. METHODS: At trial conclusion, we surveyed 39 primary care providers (PCPs) to identify preferences about components of the clinic intervention, conducted two focus groups among non-PCP staff to elicit in-depth attitudes and experiences with operationalizing the team-based CKD registry, and conducted eight focus groups with English- and Spanish-speaking patients to hear about their experiences with the CKD-SMS program. Focus group transcripts were analyzed using thematic analysis. Self-reported participation and data from the automated telephone program were used to evaluate patient engagement. RESULTS: Most PCPs (94%) believed that the point-of-care notifications benefited clinic workflow and agreed that quarterly feedback enhanced their ability to identify (89.5%) and manage (73.7%) CKD. Staff confirmed usefulness of point-of-care notifications. Patients suggested the automated telephone system was impersonal, though easy to use; that frequent automated calls were helpful to reinforce self-management behaviors; and that telephone health coaching was convenient. Nearly 40% of patients completed >80% of automated phone calls, 95% participated in calls with their health coach and 77% created at least one action plan. CONCLUSIONS: A CKD registry is acceptable to primary care health care teams and has potential to enhance identification and management of CKD in primary care. Low-income patients appreciated and engaged with a telephone-based CKD-SMS program, demonstrating its potential for increasing awareness and health engagement among populations with CKD within a public health care delivery system.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Qualitative_research Aspecto: Implementation_research Idioma: En Revista: Clin Kidney J Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Qualitative_research Aspecto: Implementation_research Idioma: En Revista: Clin Kidney J Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido