Improving Drug- and Disease-related Knowledge of Patients with Chronic Kidney Disease: Randomized Controlled Trial from a Sri Lankan Outpatient Clinic

Abstract

ABSTRACT Context: During past decades, the prevalence of chronic kidney disease (CKD) has increased significantly. Individuals with CKD are on complex drug regimens. Enhancing patients’ disease and medication knowledge can be achieved by pharmacist-conducted patient education. Aims: This study aimed to assess disease-specific knowledge changes in patients with stage 4 or 5 CKD after providing patient education. Settings and Design: A randomized controlled clinical trial was conducted at an outpatient renal clinic, Teaching Hospital, Anuradhapura, Sri Lanka. Subjects and Methods: The clinic admission register was used as the sampling frame. Patient consent was obtained, and demographic data were collected at commencement. Four counseling sessions were provided to the intervention group (IG) by “clinic-based pharmacist,” at commencement, and 2, 6, and 10 months, post-recruitment. The control group (CG) received usual care. A validated “drug and disease knowledge questionnaire” was interviewer administered to both groups at 6 months and a “drug and disease information booklet” was provided to IG. The same questionnaire was readministered at 12 months to reassess disease-specific knowledge. CG received an education booklet at 12 months. Statistical Analysis Used: The Mann–Whitney U test was used to analyze initial and 12 months in-between group data. The Wilcoxon signed-rank test was used to analyze initial and 12-month data within CG and IG. Results: One hundred patients were enrolled in CG and 101 in IG. The demographic profile of the two groups was broadly similar. Median drug and disease knowledge questionnaire scores were similar at 6 months at 23.00 (19.25–26.00) in CG and 24.00 (20.00–27.00) in IG (P > 0.05). At 12-month scores were 22.00 (18.00–25.50) in CG compared to 35.00 (31.00–37.00) in IG (P < 0.05). Conclusions: The provision of medication counseling and a “drug and disease information booklet” is beneficial in improving disease-specific knowledge in patients with CKD.