Using Digital Solutions to Improve Transition of Care for Patients with Acute Kidney Injury

Title: Using Digital Solutions to Improve Transition of Care for Patients with Acute Kidney Injury The overarching objective of the proposed mentored patient-oriented career development award (K23) is to develop an acute kidney injury (AKI) research program that utilizes behavioral science principles and digital health solutions, fostering Dr. Ng’s development to an independent researcher. AKI, a sudden decline in kidney function, occurs in 16-25% of hospitalized patients. If AKI is not addressed during the transition of care from the hospital to outpatient setting, patients are at risk for recurrent AKI and rehospitalization. Achieving optimal transition of care for AKI is challenging, because AKI information is poorly communicated both to outpatient providers and patients. Outpatient providers cannot address AKI complications nor monitor kidney function, when they are unaware of patient’s AKI status. Additionally, patients lack the knowledge and self-management skills for AKI (e.g., follow kidney-specific dietary restrictions or avoid medications harmful to the kidneys). To improve AKI information flow to providers and patients, the candidate proposes to adapt and evaluate: 1) an AKI section for discharge summary; and 2) the feasibility of a text messages to support patient education and self-management. The Specific Aims are: 1a) adapt existing discharge summary to include AKI information, and test usability; 1b) design and adapt text messages for an AKI management and education tool (AKI-MET); and 2) evaluate the feasibility, acceptability, and preliminary efficacy of intervention components in a 2 sequential pilot RCTs. Dr Ng has completed a master’s degree in clinical epidemiology at the University of Pennsylvania, through which she gained experience in epidemiology, biostatistics, and study design. Her previous training and experience in AKI epidemiology research and qualitative research have prepared her to engage in the work proposed in the studies. Dr Ng is positioned to use this award to launch an independent research career in the rich research and training environment at the Zucker School of Medicine at Hofstra/Northwell. Through her proposed career development, she seeks to gain skills in: 1) application of health information technology and digital health intervention; 2) behavioral science and behavioral intervention design; 3) RCT design, conduct, and analysis, including longitudinal data analysis from the pilot trial; and 4) professional development. Dr. Ng has assembled a multi-disciplinary mentorship team led by experts in the field. Upon completion of these K23 activities, she will be well-positioned to submit an R01 for a larger RCT to assess the effectiveness of AKI transition-of-care tool in improving health outcomes.