Abstract: PO1382
Patient Perspectives on Frailty Status Evaluation During Kidney Transplant Assessment
Session Information
- Geriatric Nephrology: New Insights
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Geriatric Nephrology
- 1100 Geriatric Nephrology
Authors
- Wu, Henry HL, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, United Kingdom
- Rushton, Lyndsey, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, United Kingdom
- Biggins, Fiona, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, United Kingdom
- Ahmed, Aimun K., Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, United Kingdom
- Woywodt, Alexander, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, United Kingdom
Background
The concept of frailty garnered attention within nephrology in recent years, given strong associations between frailty status and kidney disease outcomes. There is increased debate on formalizing frailty status evaluation during the early stages of assessment for potential kidney transplant recipients. Studies investigating patient perspectives on frailty and frailty status evaluation during transplant assessment are lacking.
Methods
We conducted a qualitative study using cognitive interviews in English for 25 patients aged 65-85 yrs awaiting initial transplant clinic assessment. The interview enquired on patient understanding of frailty, perspectives on the impact of frailty for transplantation outcomes and whether formalized frailty status evaluation during transplant assessment should be established. An inductive thematic analysis of interviews to identify themes reflecting participants’ awareness, understanding and perspectives of frailty and frailty status evaluation in transplant assessment was performed.
Results
There were 14 Male and 11 Female participants and mean age was 69.6 yrs ± 3.4. Participants were mainly white (n=18) and native English speakers (n=20). 3 prominent themes were identified. 1) Prerequisite awareness of the frailty syndrome and recognition of its strong associations with negative health outcomes. Most participants understood frailty as a composite of declining physical function, reduced ability to perform daily activities and increased comorbidity status. 2) Severe frailty status is associated with older transplant recipients. Many participants felt worsened frailty status is correlated with older age, and older transplant recipients generally do more poorly. 8 participants recognized frailty may be independent of age in which older patients could be fitter transplant candidates compared to younger, frailer patients. 3) Universal support for a formalized screening program to evaluate frailty status during pre-transplant assessment. All participants voiced support, to assist clinical decision-making on determining suitability for transplantation from an early stage.
Conclusion
Patient education initiatives should continue to expand awareness of frailty and its implications in transplantation. Further work is required to determine an optimal approach to formally evaluate frailty status during transplant assessment.
Funding
- Government Support – Non-U.S.