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Abstract: TH-PO268

Perspectives of Pakistani Patients Receiving Maintenance Dialysis on End-of-Life and Dialysis Decision-Making

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Saeed, Fahad, University of Rochester Medical Center, Pittsford, New York, United States
  • Sardar, Muhammad, Monmouth Medical Center, Long Branch, New Jersey, United States
  • Rasheed, Khalid, Army Medical College, Pakistan, Islamabad, Pakistan
  • Naseer, Raza, Liaquat University of Medical and Health Sciences, Elgin, Illinois, United States
Background

There is a paucity of literature on end-of-life care (EoLC) and treatment preferences of Pakistani patients receiving maintenance dialysis. Most of the literature on these issues report beliefs of Western dialysis patients; however, both patient populations may differ in their cultural and religious beliefs about EoLC issues.

Methods

Using a convenient sampling method, we surveyed 522 dialysis adult patients from 7 different dialysis units across 4 cities of Pakistan from March through June 2015. The survey was adapted from the previous literature and translated in the Urdu language.

Results

The majority of the patients wanted detailed information about their disease (67.6%), and prognosis (54.4%). However, 81% reported not having prognostic discussions with their nephrologists. Only a small percentage of patients’ self-reported knowledge about services such as hospice (5%) and palliative care (8%). Nearly forty-seven percent of the respondents said that they would choose a course of treatment focused on relieving pain rather than extending life (19%). The decision to initiate dialysis over conservative management was made by doctors in 54% of the respondents. Almost 35% of the patients were not satisfied with their decision to start dialysis.

Conclusion

Pakistani patients receiving maintenance dialysis wish to receive better education on their prognosis and end-of-life care issues. Interventions to improve dialysis decision-making processes and uptake of hospice and palliative care services are needed in this population.