Patient education: can it maximize the success of therapy?

The majority of patients with chronic renal insufficiency (CRI) have only limited knowledge of their condition. Various studies of the benefits of patient education programmes have shown that educated patients have a reduced incidence of emergency dialysis compared with control patients. Additionally, more educated patients are able to start dialysis as an outpatient rather than in hospital. An education programme also allowed a greater number of blue-collar workers to remain employed after starting dialysis. The US National Pre-End-Stage Renal Disease (pre-ESRD) Education Initiative, which is currently in progress, aims to educate a large number of pre-ESRD patients on kidney function, renal failure, dialysis, and transplant options. Preliminary results suggest that the initiative influences the choice of dialysis and that, regardless of race, age, and co-morbidities, the incidence of peritoneal dialysis could be increased in ESRD patients in the US. Education on other components of therapy may also influence patient outcomes. In the management of renal anaemia, improved education, and advances in the delivery systems available for administration of erythropoietin may be important factors in improving patient compliance and maximizing the success of treatment. Thus, education of patients early in the course of CRI offers many potential benefits for patients and healthcare professionals, including improved treatment outcomes, reduced anxiety, greater prospect for continued employment, improved timing for the start of dialysis, and a greater opportunity for intervention to delay disease progression.