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Started as a small pilot support program to supplement education bynephrologists (specialized physicians trained in the diagnosis and managementof kidney disease), Baxter's KPE program provides kidney disease patients withaccess to a licensed healthcare professional who can provide unbiasedinformation about the disease and treatments, as well as one-on-one emotionalsupport.
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Typically, a CKD patient's physician will contact a Baxter KPE to "enroll"patients in regularly scheduled seminars or one-on-one meetings. To providethis personalized, face-to-face service across the country, each Baxter KPEcovers multiple states and can sometimes drive up to 3,000 miles a monthreaching out to patients. Meetings can be held in venues as large as a hotelballroom and as small as a private office in a doctor's clinic, and a KPE mayhave to speak English, Spanish or French, and depending on the audience, allthree in the same meeting.
"Many patients are overwhelmed when they are told they have CKD. Theythink that it's the end of the world because they have to go on dialysis anddon't know what to expect," says Justine Barbour, RN, a KPE based in theWashington, D.C./Baltimore area. "We let them know that dialysis is not adeath sentence - it's an opportunity to keep living. We clear upmisconceptions about CKD and treatment options, provide them an opportunity toask questions and share reliable information in an understandable way."
The growing prevalence of CKD has led to an increased need for patienteducation. The National Kidney Foundation estimates that at least 20 millionAmericans have CKD and 20 million more are at risk. About 400,000 patientshave been diagnosed with End-Stage Renal Disease (ESRD), which requiresdialysis or a kidney transplant to stay alive, and the number is projected torise to more than 660,000 by 2010.
This growth in kidney dialysis patients has created a need for not onlyreliable information, but for professionals who can translate medicalinformation into simple, understandable terms. A CKD patient transitioning toongoing dialysis treatment has to quickly learn complicated medical conceptsand how to ask their doctor the right questions about their care options. AKPE provides a valuable indirect service to nephrologists and nurses byaccelerating patient understanding and following up with patients as theyweigh their treatment options and consider lifestyle implications.
"When we first meet a patient, we reinforce what the nephrologist hasalready told them about kidney disease and provide additional information,"said Barbour. "Later, we call to see if they have any questions we can answer,so that when they go back to see their doctor, they can have a more informedconversation on what they need to do and why. We continue to follow-up untilthey begin their therapy, to address additional specific questions andconcerns that they may have."
This support is especially important for chronic kidney diseases that haveno cure and where ongoing life-sustaining treatment is needed. Numerousresearch studies on patient education have shown that patients who areactively involved in making and understanding decisions about their therapyhave better health outcomes and better adherence to their treatment plan.(1)Other studies have shown that patients who are educated and knowledgeableabout their condition and treatment options have fewer complications, and, asa result, fewer hospitalizations, emergency room, clinic and physicianvisits.(2,3)
Rashid Dalal, M.D., a Belleville, IL
