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Kidney Week

Abstract: FR-PO330

Sustained Effect of Online Peer Mentoring on Activation of Patients with CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Bartolomeo, Korey, Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Romeu, Jose C., Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Ezeji, George Chinedu, Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Lopez, Eric Mark J., Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Chinchilli, Vernon M., Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Ghahramani, Nasrollah, Penn State College of Medicine, Hershey, Pennsylvania, United States
Background

Peer mentoring (PM) has been proposed as a model for active patient engagement. This study evaluates the differences in the effect of online PM, face-to-face (FTF) PM and usual care on patient activation among chronic kidney disease (CKD) patients.

Methods

A total of 155 patients with stage 4 or stage 5 CKD were randomly assigned to online PM, FTF PM or usual care. Online PM consisted of weekly communication through an interactive online platform, and more frequently through posts initiated by the patient. For the FTF group, the frequency of contact by a mentor was weekly by phone and monthly visit. PM was maintained for 6 months. Usual care participants received an information handbook and were encouraged to discuss questions with their care team. We administered the 13-item validated Patient Activation Measure® (PAM) at baseline, at 12 months and at 18 months. We used linear mixed effect models to estimate the slope of change of PAM score over time. SAS, version 9.4 was used for data analysis.

Results

A total of 117 patients completed the 18 month assessment. Baseline PAM scores and demographic characteristics were similar among groups. The online PM group showed a significant improvement in mean PAM score between baseline and 12 months (67±15.7 vs. 77.5±12.7); improvement was sustained at 18 months (78.0±14.2) (Slope estimate [SE]:5.65;95% confidence interval [CI]:2.75, 8.52 [P=0.0001]). Among the FTF group, there was no significant change in PAM score in the 3 periods (SE:0.95;CI: -1.96, 3.86 [P=0.52]). Among the control group, there was no significant change in PAM score in the 3 periods (SE:0.02;CI:-3.03, 3.08 [P=0.99]). Slopes of change in PAM were significantly different between online and FTF groups (p=0.02), as well as online and control groups (p=0.009); there was no difference in the slopes of change in PAM between FTF and control groups (p=0.66). In subgroup analyses, the difference between the online group and other groups in slope of change in PAM was significant among male, but not female participants and among married, but not unmarried participants.

Conclusion

Online peer mentoring is associated with improved scores in Patient Activation Measure among patients with advanced CKD. This improvement is influenced by gender and marital status.

Funding: PCORI

Funding

  • NIDDK Support