Malkina Anna, Tuot Delphine S
Division of Nephrology, University of California, San Francisco, CA, USA.
Division of Nephrology, Zuckerberg San Francisco General Hospital, University of California, San Francisco, CA, USA.
Semin Dial. 2018 Mar;31(2):129-134. doi: 10.1111/sdi.12663. Epub 2018 Jan 3.
The prevalence of end-stage renal disease is rising in the United States, which bears high financial and public health burden. The most common modality of renal replacement therapy (RRT) in the United States is in-center hemodialysis. Many patients report lack of comprehensive and timely education about their treatment options, which may preclude them from participating in home-based dialysis therapies and kidney transplantation evaluation. While RRT education has traditionally been provided in-person, the rise of telehealth has afforded new opportunities to improve upon the status quo. For example, technology-augmented RRT education has recently been implemented into telehealth nephrology clinics, informational websites and mobile applications maintained by professional organizations, patient-driven forums on social media, and multimodality programs. The benefits of technology in RRT education are increased access for geographically isolated and/or medically frail patients, versatility of content delivery, information repetition to enhance knowledge retention, and interpersonal connection for educational content and emotional support. Challenges center around privacy and accuracy of information sharing, in addition to differential access to technology due to age and socioeconomic status. A review of available scholarly and social media resources suggests that technology-aided delivery of education about treatment options for end-stage renal disease provides an important alternative and/or supplemental resource for patients and families.
在美国,终末期肾病的患病率正在上升,这带来了高昂的经济和公共卫生负担。在美国,肾脏替代治疗(RRT)最常见的方式是中心血液透析。许多患者表示,他们缺乏关于治疗选择的全面且及时的教育,这可能使他们无法参与家庭透析治疗和肾脏移植评估。虽然传统上RRT教育是面对面提供的,但远程医疗的兴起为改善现状提供了新机会。例如,技术增强型RRT教育最近已应用于远程医疗肾脏病诊所、专业组织维护的信息网站和移动应用程序、社交媒体上患者驱动的论坛以及多模式项目。技术在RRT教育中的好处包括增加了地理上孤立和/或身体虚弱患者的可及性、内容传递的多样性、信息重复以增强知识保留,以及教育内容和情感支持的人际联系。挑战主要围绕信息共享的隐私和准确性,以及由于年龄和社会经济地位导致的技术获取差异。对现有学术和社交媒体资源的回顾表明,技术辅助的终末期肾病治疗选择教育为患者和家庭提供了重要的替代和/或补充资源。