Poster: Kidney Essentials: chronic kidney disease and acute kidney injury programmes

This poster was presented at the UK Kidney Week in 2023. Kidney Essentials: CKD and AKI was developed with the Royal Berkshire NHS Foundation Trust who wanted to redesign the delivery of their outpatient service, with greater focus on virtual care, and remote ways of providing accessible and impactful patient education.

Kidney Essentials is an engaging and accessible health information programme, that uses avatars in multiple languages to help patients understand their renal health and how to self-manage their condition.

ABSTRACT 

Authors and affiliations  

Emma Vaux, MD1; Emma Bishop2; Becca Sharman2; Tim Ringrose2; Jake Sykes2; Daisy Allington2; Andy Begg2; Mohammad Hamza2; Rick Knowles2  

1Royal Berkshire NHS Foundation Trust, Reading, UK; 2Cognitant Group Ltd, Oxford, UK 

Background 

Low health literacy in chronic kidney disease (CKD) is associated with worsening kidney function, increased hospitalisation and mortality. In general, patients from ethnic minority backgrounds have lower health literacy rates owing to language and cultural barriers, compared with their white counterparts. The Royal Berkshire NHS Foundation Trust partnered with Cognitant, a healthcare technology company, to develop a digital interactive care model to improve patient health literacy and understanding of CKD. The pilot programme received positive feedback from users, who reported that the digital information was easy to understand and more effective in increasing their knowledge of CKD compared with traditional printed information. In this Phase 2 expansion, the aim was to improve accessibility of the digital platform and the existing CKD material, particularly for ethnic minority groups, and to develop a digital platform for patients with acute kidney injury (AKI).  

Methods 

A multidisciplinary co-creation approach was used (patients, nephrology, primary care, pharmacy and dieticians). Languages most appropriate for the Berkshire region were identified using data from local practice records regarding translator requests during patient consultations. To further improve accessibility, patient feedback from the pilot programme was assessed. User engagement was measured by time spent per session, and a digital feedback questionnaire assessed ease of use, effectiveness and patients’ preferences using a 5-point Likert scale, ranging from ‘No’ – ‘Sort of/It was ok’ – ‘Yes’. A co-creation approach was adopted to develop a similar programme for patients with AKI. 

Results 

Consultation records indicated that Polish, Nepali, Punjabi and Urdu were highly requested for translation in local Berkshire practices during patient consultations. Cultural adaption of the CKD programme included translation into these languages, the inclusion of culturally appropriate avatars and culturally specific changes to the content, such as nutritional advice. Based on patients’ feedback from Phase 1, the programme was redeveloped to be fully web-based. Metric data on patient engagement indicated that on average, users spent 9 minutes 23 seconds on the programme per session and feedback from the questionnaire was generally positive. Most patients who provided responses reported that they enjoyed the video about CKD, they found the site easy to use and they knew more about CKD after watching the video (Figure). The co-creation process for the AKI programme enabled the development of similar materials for patients with AKI, including an interactive video, available in multiple languages, and a quiz to improve engagement and knowledge retention. 

Discussion 

Expansion of the CKD digital interactive care model supports the aim of increasing accessibility of visual digital information, particularly for patients from ethnic minority backgrounds. Translation into regionally relevant languages and cultural adaptation has wide applicability and the potential to tackle health inequalities by empowering underserved patients with reliable and easy-to-understand information. The next steps of the programme include gathering data on engagement with the translated services, extending the CKD education programme to more regions, and launching and analysing the AKI programme. 

Figure. Patient responses from digital feedback questionnaire using a Likert scale to assess attitudes towards the digital platform and the information presented. 

 Biography

Dr Emma Vaux OBE DPhil FRCP is a Consultant Nephrologist and General Physician at the Royal Berkshire NHS Foundation Trust where she is Clinical Lead, Berkshire Kidney Unit; Clinical Director, integrated medicine; and Medical Associate Director, patient safety. She is immediate Royal College of Physicians past Vice President (education & training) and Chief Examiner. She led on the development of the RCP500 Code of Conduct. She is a Health Foundation Generation Q Fellow and founding member of the Q Community. Emma is Co-editor of ABC Quality Improvement in Healthcare and Associate Editor of Future Healthcare Journal. Emma was awarded an OBE for services to medical education in 2021.