October 29, 2024
2 minute read
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Important points:
Health literacy, stage 5 kidney disease, and hypertension were associated with replacement therapy. After the intervention, 94.5% of patients were able to express a preference for renal replacement therapy.
SAN DIEGO — An educational intervention improved dialysis decision-making in veterans with advanced chronic kidney disease, according to data presented at Kidney Week.
Researchers led by Anuradha Wadhwa, M.D., a nephrologist at Edward Hines Jr. Veterans Affairs Hospital in Hines, Illinois, conducted a prospective cohort study of five Veterans Affairs health systems in Florida, Utah, and Illinois. carried out. The objective was to evaluate the effect of a comprehensive predialysis education program on decision-making regarding renal replacement therapy (KRT).
Health literacy, stage 5 kidney disease, and hypertension were associated with replacement therapy. Image: Adobe Stock.
“What we’re trying to do here is figure out whether we’re suggesting that most people should do home dialysis. [and if] Patients are really interested,” Ashutosh M. Shukla, M.D., a researcher at the Veterans Affairs North Florida-South Georgia Veterans Affairs Health System in Gainesville, Florida, told Helio. “This is really important because it’s the patient who makes this choice. If most people don’t have a choice, what predicts their decision-making ability?”
The study included 218 rural-dwelling veterans who received comprehensive predialysis education from 2023 to 2024. Informed treatment choice was defined as KRT with a confidence level of 60% or higher on a scale of 0% to 100%.
Researchers assessed gaps in decision-making before and after comprehensive predialysis education, taking into account patient characteristics.
Findings showed that 9% of veterans reported receiving decision-making support and 9% received comprehensive predialysis education prior to the intervention. 38.5% if patient was able to support hypothetical KRT modality prior to comprehensive predialysis education; After the intervention, 94.5% were able to express a preference for KRT.
Shukla et al.’s study showed that the preference for home dialysis in their cohort increased from 21% with comprehensive predialysis education to 82% after education.
Researchers identified key factors influencing pre-intervention decision-making. Optimal health literacy, stage 5 CKD, and hypertension were associated with higher odds of choosing KRT. Post-intervention treatment choices were influenced solely by patient perceptions of CKD and end-stage renal disease.
Researchers found that veterans’ confidence in their choices improved after the intervention.
Shukla said system-wide educational interventions could help veterans feel confident in their dialysis options and increase home dialysis.
“Our job is to provide patient education so that they can make better decisions, make more decisions, and in order to do that, they have knowledge about what dialysis is. We need to do it better,” Shukla said.
Publisher: Source/Disclosure
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sauce:
Wadhwa A, et al. TH-PO315. Presentation location: ASN Kidney Week; October 24-27, 2024. San Diego.
Disclosure: This research was supported by the U.S. Department of Veterans Affairs.
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