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Knowledge is a prerequisite for changing behavior, and is useful for improving outcomes and reducing mortality rates in patients diagnosed with chronic kidney disease (CKD). The purpose of this article is to describe baseline CKD knowledge and awareness obtained as part of a larger study testing the feasibility of a self-management intervention. Thirty patients were recruited who had CKD Stage 3 with coexisting diabetes and hypertension. Fifty-four percent of the sample were unaware of their CKD diagnosis. Participants had a moderate amount of CKD knowledge. This study suggests the need to increase knowledge in patients with CKD Stage 3 to aid in slowing disease progression. [ABSTRACT FROM AUTHOR]

The SystemCHANGE™ intervention has led to great improvements in medication adherence, which is a challenge for nearly one-third of kidney transplant recipients. This secondary data analysis sought to measure the frequency of individual solutions utilized by participants in a previously conducted randomized controlled trial of the SystemCHANGE™ intervention and to determine which classes of solutions had greatest impact on improved medication adherence. Solutions that were significant predictors of improving medication adherence to the 85% or higher level included alarm cues (p ≤ 0.0001), time cues (p = 0.006), restructuring the physical environment (p = 0.048), and social support (p = 0.023). Alarm and time cues, restructuring the environment, and social support were successful solutions largely influenced by personal routine and environment consideration that might be prioritized in future studies when implementing SystemCHANGE™. [ABSTRACT FROM AUTHOR]

Problem: Approximately 50% of Americans with chronic kidney disease (CKD) are in Stage 3, which has a better success rate for slowing progression of CKD than later stages. Purpose: The Self-Management of Chronic Illness study was conducted to examine the feasibility of Intervention Strategies to Overcome Progression of CKD (ISTOP-CKD) for patients with Stage 3 CKD and coexisting diabetes and hypertension. ISTOP-CKD is a phone-based health coaching self-management intervention designed to build knowledge, skill and self-efficacy, based upon the degree of activation. Methods: A two-group randomized controlled pilot study was conducted over 12-weeks to (1) examine the feasibility and acceptability of delivering ISTOP-CKD and an attention control intervention; (2) compare activation, knowledge, self-efficacy, and self-management skills in the two groups and; (3) estimate the impact of ISTOP-CKD on medication adherence, clinical markers, health-related quality of life, and satisfaction with care at baseline, end of 6-week intervention, and 6-weeks following intervention. Findings: Participants were randomized to the ISTOP-CKD (n=15) and attention control groups (n=15) and were predominantly female, black, not Hispanic/Latino, educated beyond high school, married, nonsmokers and unaware of their CKD (54%) at baseline. Knowledge significantly increased in the ISTOP-CKD group (p<.05). There were no differences between groups or over time in activation, self-efficacy, self-management, medication adherence, quality of life, or care satisfaction. Incomplete clinical marker data was available. Implications: Recruiting Stage 3 CKD patients is challenging; this study highlights the importance of increasing patients' awareness of CKD in stage 3 to increase patient activation, self-management and slow CKD progression. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) is associated with other multiple chronic conditions such as diabetes and hypertension. Slowing disease progression requires patients to integrate daily medication taking into their daily routines, which is difficult. Behavioral interventions have focused on the outcome of medication adherence and have virtually ignored medication-taking behaviors which limits long-term effectiveness. To inform medication adherence interventions, information is needed to explicate the nature of the relationships between behaviors that support medication taking and medication adherence. The aim of this study was to identify patients' behaviors associated with taking medications and medication adherence in adults with CKD and multiple chronic conditions. Method: A literature search was conducted using CINAHL Complete, MED-LINE and PsycINFO. We systematically reviewed qualitative studies reporting patients' experiences with chronic kidney disease and medication management. We conducted a meta-ethnographic synthesis of 5 qualitative studies meeting quality criteria to identify medication-taking behaviors. Findings: Medication taking is complex. Our preliminary review identified 20 categories of behaviors involved in managing multiple medications for multiple chronic conditions. These behaviors were carried out in patients' daily lives and involved interactions with family members, healthcare providers and the healthcare system. Healthcare insurance, regulation and pharmaceutical availability added to the complexity of medication taking behaviors. Conclusions: Day to day management of CKD and chronic conditions requires consistent yet complex medication-taking behaviors. Nephrology nurses can partner with patients to elucidate how these behaviors are enacted in day-to-day management and identify opportunities to intervene on specific behaviors to promote medication adherence. [ABSTRACT FROM AUTHOR]