Effectiveness of Health Literacy Program for Polypharmacy Patients (HLP-CKD)

Background: Patients with polypharmacy are at a higher risk of drug-induced kidney injury. Enhancing health literacy is a key strategy to empower these patients to engage in protective health behaviors.

Objectives: 1) To compare health literacy scores before and after participating in the program. 2) To compare CKD prevention behaviors between the experimental and control groups.

Methodology: This is a quasi-experimental study with a pre-test/post-test design.

Experimental Group: Receives the "Health Literacy Promotion Program," which includes educational sessions, skill-building for medication management, and follow-up support.

Control Group: Receives routine nursing care and standard health education. Intervention Details: The program focuses on 6 aspects of health literacy: access, understanding, communication, questioning, decision-making, and practice.

Data Collection: Data will be collected using validated questionnaires for health literacy and CKD prevention behavior at baseline and after the intervention (e.g., at week 12).

Analysis: Descriptive statistics and t-tests (Independent and Paired) will be used to evaluate the program's effectiveness.

• Health Literacy Promotion Program (HLP-CKD) (Behavioral): An 8-week program consisting of educational sessions, skill-building for medication management, and follow-up support to prevent chronic kidney disease.

Primary outcomes

• Health Literacy Levels [Baseline, 8 weeks (immediately after intervention), and 12 weeks (follow-up).]: The total score of health literacy regarding chronic kidney disease (CKD) prevention, assessed using a validated Health Literacy Questionnaire. The tool evaluates 6 domains: access, understanding, communication, questioning, decision-making, and practice. Higher scores indicate a higher level of health literacy.
• CKD Prevention Behaviors [Baseline, 8 weeks, and 12 weeks.]: The assessment of self-care behaviors to prevent chronic kidney disease, such as medication adherence, dietary control, and physical activity. Evaluated using the CKD Prevention Behavior Scale.

Secondary outcomes

• Estimated Glomerular Filtration Rate (eGFR) [Baseline and 12 weeks (follow-up)]: A key indicator of kidney function calculated based on serum creatinine level, age, and sex. It is used to monitor the stage of chronic kidney disease.
• Serum Creatinine [Baseline and 12 weeks (follow-up)]: A waste product in the blood that is filtered by the kidneys. This value is used to calculate the eGFR and evaluate kidney health.
• Urine Albumin-to-Creatinine Ratio (UACR) [Baseline and 12 weeks (follow-up).]: A marker used to detect albuminuria (protein in the urine), which is an early sign of kidney damage, especially in patients with chronic diseases.

Sex: All, ages: 55 Years to 74 Years

Inclusion Criteria:

* Patients aged 55-74 years diagnosed with non-communicable diseases.
* Currently taking 5 or more medications daily (Polypharmacy) for at least 6 months.
* Have at least one risk factor for chronic kidney disease (e.g., Hypertension or Diabetes).
* Able to communicate, read, and write in Thai.
* Willing to participate in the 8-week program and follow-up assessments.

Exclusion Criteria:

* Patients already diagnosed with Chronic Kidney Disease (CKD) stage 3 - 5.
* Having severe cognitive impairment or psychiatric disorders that prevent participation.
* Having severe complications or being in an unstable clinical condition.
* Planning to move out of the study area during the 12-week study period.

• Wanpen Waelveerakup, Dr.P.H., Principal investigator, Faculty of Nursing, Nakhon Pathom Rajabhat University