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Abstract: FR-PO860

Patient and Physician Perspectives on Treatment Burden in ESKD: a Nominal Group Technique Study

Session Information

Category: Diversity and Equity in Kidney Health

  • 800 Diversity and Equity in Kidney Health

Authors

  • Thomas, Sarah T., Gold Coast Hospital and Health Service, Southport, Queensland, Australia
  • Sav, Adem, Queensland University of Technology Faculty of Health, Kelvin Grove, Queensland, Australia
  • Thomas, Rae, Bond University Faculty of Health Sciences and Medicine, Gold Coast, Queensland, Australia
  • Cardona, Magnolia, Bond University Faculty of Health Sciences and Medicine, Gold Coast, Queensland, Australia
  • Michaleff, Zoe A., Bond University Faculty of Health Sciences and Medicine, Gold Coast, Queensland, Australia
  • Titus, Thomas T., Gold Coast Hospital and Health Service, Southport, Queensland, Australia
  • Dobler, Claudia Caroline, Bond University Faculty of Health Sciences and Medicine, Gold Coast, Queensland, Australia
Background

The treatment workload associated with end stage kidney disease (ESKD) is high. The treatment burdens experienced by ESKD patients are not well understood. We aimed to elucidate the most important areas of treatment burden for discussion in a clinical encounter from ESKD patients and nephrologists' perspectives, as well as possible solutions to these treatment burden challenges.

Methods

ESKD participants with diverse characteristics were purposively recruited from one tertiary treatment centre in Queensland, Australia. Nominal group technique (NGT), a mixed-methods consensus approach, was used to collect data. Treatment burden themes generated were ranked in order of importance. Three in-person NGT sessions were conducted with ESKD patients. One online NGT session was conducted with nephrologists from two Australian states.

Results

Nineteen dialysis-dependent ESKD patients (mean age 64 years; range 47-82) and six nephrologists participated. All patients were retired or on a disability pension; 74% perceived moderate or severe treatment burden; 90% spent more than 11 hours on treatment-related activities per week (range 11-30). Every patient group ranked health system issues as the most important treatment burden priority encompassing lack of continuity and coordination of care, dissatisfaction with frequent healthcare encounters and challenges around healthcare access. Physicians perceived psychosocial burdens of treatment to be most important to patients and families, which was ranked the second highest priority by patients.

Conclusion

Discussing treatment burden in a clinical encounter may lead to a better understanding of patients’ capacity to cope with their treatment workload. This could facilitate tailored care, improve health outcomes, treatment sustainability, and patients’ overall quality of life.