Use of Google Analytics to Explore Dissemination Activities for an Online CKD Clinical Pathway: A Retrospective Study

Identifying strategies for disseminating research to patients with chronic kidney disease and caregivers: a workshop report

Health research results are primarily disseminated through scientific peer-reviewed journals and are not readily accessible to patients and caregivers, which can impede informed decision-making and limit the impact of research on patient outcomes. The aim of the workshop was to identify strategies to disseminate research in chronic kidney disease (CKD) to patients and caregivers. The workshop involved patients, caregivers (n = 27), and health professionals (n = 54) from Australia (10 breakout groups). The transcripts were thematically analyzed. Three themes (strategies) were identified. Generating interest encompassed emphasizing the benefits and impacts of research, using engaging modes of delivery, increasing visibility in clinical settings, and harnessing popular culture. Eliminating barriers to access included ensuring free access to journal articles, translating into different languages, providing plain-language summaries, considering convenience in the context of CKD-related burdens, and maximizing exposure. Demonstrating trustworthiness and repute entailed filtering for high-quality information and propagating through familiar networks and community-based channels. Ensuring ease of access to research, drawing attention, and prompting motivation to engage in research, and instilling confidence in patients about the quality of research may support effective dissemination. Adopting patient-prioritized models to increase translation of research may support shared decision-making in practice and improve care and patient outcomes.

Constructing TheKeep.Ca With Thrivers of Cancer in Manitoba, Canada, in Support of Enhancing Patient Engagement: Protocol for a Pragmatic Multimethods Study

BACKGROUND

TheKeep.Ca was built to facilitate engagement with those experiencing cancer in Manitoba, Canada. Constructed between 2020 and 2024 with a group of patient advisors, the website includes information on engagement activities including research participation, the patient advisor role, and how those experiencing cancer can access these Manitoba activities. A link allows visitors to register to be contacted about activities that match their demographics, cancer history, and activity preferences. After TheKeep.Ca was constructed, this protocol was developed to establish TheKeep.Ca as a platform for scientific research focused on optimally engaging those experiencing cancer.

OBJECTIVE

We asked the following questions: (1) What was the patient advisors' experience who participated in developing TheKeep.Ca? (2) What are the baseline characteristics of website traffic and registrants at TheKeep.Ca? (3) How does registering with TheKeep.Ca impact the cancer experience?

METHODS

The planned launch date for the website and initiation of research activities is January 2025. For objective 1, the active patient advisors (N=6) participating in the website project will be invited to participate in project activities including with responses to a question prompt sheet, semistructured audio-recorded interviews, or both. Responses and interviews will be analyzed using reflexive thematic analysis to understand and inform practices for patient engagement on projects. At the website launch, TheKeep.Ca will become publicly accessible and indexable on internet search engines, but no additional promotional interventions will take place in the initial 6 months resulting in visitors primarily from web search traffic. For objective 2, Google Analytics and website registrant data collected during the first six months will be analyzed to obtain baseline characteristics of website visitors. For objective 3, an online survey will be emailed to registrants six months after the website launch characterizing their website experience, the activities they participated in, and collecting feedback on the website. For objectives 2 and 3, quantitative data will be analyzed using both descriptive and inferential statistics, and qualitative data from open-ended questions will be analyzed using thematic analysis guided by an inductive descriptive semantic approach.

RESULTS

This study was approved by the University of Manitoba Health Research Ethics Board on December 12, 2024 (HS26614-H2024L263). Institutional approval from CancerCare Manitoba is pending as of December 23, 2024. Findings from objective 1 are expected to be finalized within the first six months after the website launch. Those from objectives 2 and 3 are expected by the 12-month mark. Reporting will include peer-reviewed journals, conferences, and a lay-language summary on TheKeep.Ca.

CONCLUSIONS

The research outlined in this protocol will facilitate understanding patient advisors' experience in developing TheKeep.Ca. It will also characterize the website' effectiveness and its impact on the cancer experience, providing a baseline and direction for future research and development.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/63597.

Assessing the Safety, User Acceptability, Dissemination, and Reach of a Comprehensive Web-Based Resource on Medications for Opioid Use Disorder (MOUD Hub): Protocol for a Development and Usability Study

BACKGROUND

Medications for opioid use disorder (MOUD), such as methadone and buprenorphine, are the gold standard for opioid use disorder (OUD) treatment. Owing to various barriers, MOUD access and retention are low in the United States. The internet presents a digital solution to mitigate barriers, but a comprehensive and reliable resource is lacking. We present a user-friendly, web-based resource, the MOUD Hub, that provides reliable information on MOUD.

OBJECTIVE

This study aims to assess the safety, acceptability, feasibility of dissemination, and reach of the MOUD Hub using focus groups and advertising on 1 key search engine and 1 social media platform.

METHODS

This protocol describes the development of the MOUD Hub and the descriptive observational feasibility study that will be undertaken. The MOUD Hub uses motivational interviewing principles to guide users through the stages of change. The website provides evidence-based information from national health and substance use agencies, harm reduction organizations, and peer-reviewed literature. First, pilot focus groups with 10 graduate students who have lived experience with OUD will be conducted to provide feedback on safety concerns. Then, focus groups with 20-30 potential MOUD Hub users (eg, people with OUD with and without MOUD experience, friends and family, and health care providers) will be conducted to assess safety, acceptability, reach, and usability. Data will be analyzed using inductive thematic analysis. The website will be advertised on Google and MOUD-specific Reddit forums to assess dissemination, reach, and user acceptability based on the total user volume, sociodemographic characteristics, pop-up survey responses, and 1-year engagement patterns. This information will be collected through Google Analytics. Potential differences between users from Google and Reddit will be assessed.

RESULTS

The MOUD Hub will be launched in January 2025. Data collected from 5 focus groups (approximately 30-40 participants) will be used to improve the website before launching it. There is no target sample size for the second stage of the study as it aims to assess dissemination feasibility and reach. Data will be collected for a year, analyzed every 3 months, and used to improve the website.

CONCLUSIONS

The MOUD Hub offers an innovative theory-based approach, tailored to people with OUD and their family and friends, to increase access to and retention in MOUD treatment in the United States and provides broader harm reduction resources for those not currently in a position to receive treatment or those at risk of resuming illicit opioid use. Findings from this feasibility phase will serve to better tailor the MOUD Hub. After modifying the website based on our findings, we will use a randomized controlled trial to assess its efficacy in increasing MOUD access and retention, contributing to growing research on web-based interventions for OUD.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/57065.

Optimizing Care Delivery in Patients with Chronic Kidney Disease in the United States: Proceedings of a Multidisciplinary Roundtable Discussion and Literature Review

BACKGROUND

Approximately 37 million individuals in the United States (US) have chronic kidney disease (CKD). Patients with CKD have a substantial morbidity and mortality, which contributes to a huge economic burden to the healthcare system. A limited number of clinical pathways or defined workflows exist for CKD care delivery in the US, primarily due to a lower prioritization of CKD care within health systems compared with other areas (e.g., cardiovascular disease [CVD], cancer screening). CKD is a public health crisis and by the year 2040, CKD will become the fifth leading cause of years of life lost. It is therefore critical to address these challenges to improve outcomes in patients with CKD.

METHODS

The CKD Leaders Network conducted a virtual, 3 h, multidisciplinary roundtable discussion with eight subject-matter experts to better understand key factors impacting CKD care delivery and barriers across the US. A premeeting survey identified topics for discussion covering the screening, diagnosis, risk stratification, and management of CKD across the care continuum. Findings from this roundtable are summarized and presented herein.

RESULTS

Universal challenges exist across health systems, including a lack of awareness amongst providers and patients, constrained care team bandwidth, inadequate financial incentives for early CKD identification, non-standardized diagnostic classification and triage processes, and non-centralized patient information. Proposed solutions include highlighting immediate and long-term financial implications linked with failure to identify and address at-risk individuals, identifying and managing early-stage CKD, enhancing efforts to support guideline-based education for providers and patients, and capitalizing on next-generation solutions.

CONCLUSIONS

Payers and other industry stakeholders have opportunities to contribute to optimal CKD care delivery. Beyond addressing the inadequacies that currently exist, actionable tactics can be implemented into clinical practice to improve clinical outcomes in patients at risk for or diagnosed with CKD in the US.

Trends in nephrology referral patterns for patients with chronic kidney disease: Retrospective cohort study

Introduction

Information on early, guideline discordant referrals in nephrology is limited. Our objective was to investigate trends in referral patterns to nephrology for patients with chronic kidney disease (CKD).

Methods

Retrospective cohort study of adults with ≥1 visits to a nephrologist from primary care with ≥1 serum creatinine and/or urine protein measurement <180 days before index nephrology visit, from 2006 and 2019 in Alberta, Canada. Guideline discordant referrals were those that did not meet ≥1 of: Estimated glomerular filtration rate (eGFR) ˂ 30 mL/min/1.73m², persistent albuminuria (ACR ≥ 300 mg/g, PCR ≥ 500 mg/g, or Udip ≥ 2+), or progressive and persistent decline in eGFR until index nephrology visit (≥ 5 mL/min/1.73m²).

Results

Of 69,372 patients with CKD, 28,518 (41%) were referred in a guideline concordant manner. The overall rate of first outpatient visits to nephrology increased from 2006 to 2019, although guideline discordant referrals showed a greater increase (trend 21.9 per million population/year, 95% confidence interval 4.3, 39.4) versus guideline concordant referrals (trend 12.4 per million population/year, 95% confidence interval 5.7, 19.0). The guideline concordant cohort were more likely to be on renin-angiotensin system blockers or beta blockers (hazard ratio 1.14, 95% confidence interval 1.12, 1.16), and had a higher risk of CKD progression (hazard ratio 1.09, 95% confidence interval 1.06, 1.13), kidney failure (hazard ratio 7.65, 95% confidence interval 6.83, 8.56), cardiovascular event (hazard ratio 1.40, 95% confidence interval 1.35,1.45) and mortality (hazard ratio 1.58, 95% confidence interval 1.52, 1.63).

Conclusions

A significant proportion nephrology referrals from primary care were not consistent with current guideline-recommended criteria for referral. Further work is needed to identify quality improvement initiatives aimed at enhancing referral patterns of patients with CKD.