Abstract: SA-PO931

Patient Engagement in ESRD: Do Patients Know Who Their Nephrologist Is?

Session Information

  • Educational Research
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Nephrology Education

  • 1301 Educational Research

Authors

  • Sekar, Arjun, Cleveland Clinic Foundation, University Heights, Ohio, United States
  • Wong, Leslie P., Cleveland Clinic, Solon, Ohio, United States
Background

Patient engagement describes how involved patients are in their care. We observed that some hospitalized dialysis patients are unable to describe their care, including who their nephrologist is. We hypothesize that patients unaware of these basic details may not actively participate in their care. We performed a survey to assess perceptions of the patient-doctor relationship and dialysis care.

Methods

We included hospitalized adult ESRD patients requiring hemodialysis. Intensive care, peritoneal dialysis and non-English speaking patients were excluded. Subjects completed a questionnaire about routine aspects of their dialysis care. We did a descriptive analysis of their responses and attempted to identify trends based on whether or not they knew their nephrologist’s name.

Results

Of 66 patients approached, 44 completed the survey. Over one-fifth (23%) did not know their attending nephrologist and 54% said a different nephrologist also rounded on them at dialysis. 74% felt their nephrologist answered their concerns promptly; 44% raised their health concerns with the nephrologist all the time. Only 24% were aware of palliative options. While 93% felt maintaining their dry weight was important to their health, only 60% knew their dry weight. Though 90% thought fluid restriction was important, only 60% stated they were compliant. Most (86%) thought controlling phosphorus was necessary but fewer (64%) were aware of its adverse effects. Sub-analysis of responses (Table) was done based on whether or not patients knew their attending nephrologist.

Conclusion

This study aimed at assessing patient engagement in ESRD. A number of patients reported disjointed perceptions of their dialysis care, including an inconsistent relationship with an attending nephrologist. This might impact discussions about palliative care and willingness of patients to follow advice. Better awareness and focus on the patient- nephrologist relationship in dialysis is needed.

RESPONSES BASED ON WHETHER PATIENTS KNEW THEIR NEPHROLOGIST
 YES=34NO=10
DIFFERENT NEPHROLOGISTS ROUNDING ON THEM58%40%
LIKELY TO FOLLOW NEPHROLOGISTS ADVICE86%56%
AWARE OF PALLIATIVE CARE28%10%
KNOW THEIR DRY WEIGHT66%33%
COMPLIANT WITH FLUID RESTRICTION91%88%
AWARE OF ADVERSE EFFECTS OF PHOSPHORUS74%30%
THINK DIALYSIS IMPROVES QUALITY OF LIFE74%71%