JMIR Publications

ABSTRACT

Background:

Chronic kidney disease (CKD) is a health condition that threatens patient safety, yet few interventions provide patient-centered education about kidney-specific safety hazards.

Objective:

We sought to develop and usability test a mobile tablet-based educational tool designed to promote patient awareness of relevant safety topics in CKD.

Methods:

We used plain language principles to develop educational content for the educational tool, targeting four patient-actionable safety objectives relevant for individuals with CKD. These four objectives encompassed: 1) avoidance of non-steroidal anti-inflammatory drugs (NSAIDs); 2) hypoglycemia awareness (among individuals with diabetes); 3) temporary cessation of certain medications while acutely volume deplete to prevent acute kidney injury (i.e. “sick day protocol”); and 4) contrast dye risk awareness. Our teaching strategies optimized human-computer interaction and content retention using audio, animation, and clinical vignettes to reinforce themes. For example, using a vignette of a patient with CKD with pain and pictures of common NSAIDs, participants are asked, “Which of the following pain medicines are safe for Mr. Smith to take for his belly pain?” Assessment methods consisted of pre- and post-knowledge surveys, with provision of correct responses and explanations. Usability testing of the tablet-based tool was performed among 12 patients with any stage of CKD, and program tasks completion were rated as 1) no error, 2) non-critical error (self-corrected), or 3) critical error (needing assistance).

Results:

The 12 participants in this usability study were predominantly 65 years old and older and female (each 58%); all participants owned a mobile device and used it daily. Of the 725 total tasks that they completed, there were 31 (4%) non-critical errors and 15 (2%) critical errors; one participant accounted for 30 of all total errors. Ten out of 12 (83%) participants easily completed 90% or more of their tasks. Most participants rated use of the tablet as ‘very easy’ (n=7; 58%), activity length as ‘just right’ (vs too long/short) (n=10; 83%), the use of clinical vignettes as helpful (n=10; 83%), and all participants would recommend this activity to others. The median rating of the activity was ‘8’, on a scale of one to 10 (best). We incorporated all participant recommendations into the final version of the educational tool.

Conclusions:

A tablet-based patient safety educational tool is acceptable and usable among individuals with CKD. Future studies leveraging iterations of this educational tool will explore its impact on health outcomes in this high-risk population.