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Kidney Week

Abstract: FR-PO890

Optimizing Veteran Video Connect: Engaging Veterans with Advanced Kidney Disease in Goals of Care Conversations

Session Information

  • Geriatric Nephrology
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

  • 1300 Geriatric Nephrology

Authors

  • Limaye, Seema S., Edward Hines Junior VA Hospital, Hines, Illinois, United States
  • Markossian, Talar, Loyola University Chicago, Chicago, Illinois, United States
  • Vahlkamp, Alexi, Edward Hines Junior VA Hospital, Hines, Illinois, United States
  • Ray, Cara Elizabeth, Edward Hines Junior VA Hospital, Hines, Illinois, United States
  • Balbale, Salva, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Stroupe, Kevin, Edward Hines Junior VA Hospital, Hines, Illinois, United States
  • Schneider, Julia, Loyola University Health System, Maywood, Illinois, United States
Background

Chronic kidney disease (CKD) prevalence and its associated morbidity and mortality is higher among Veterans than in the general population. As such, goals of care conversations (GOCC) are indicated. Little is known regarding the use of tele-palliative consultation for GOCC in older adult Veterans with CKD. This pilot study examined the acceptability, facilitators, and barriers of engaging this population in GOCCs via telehealth.

Methods

This study used prospective observational design and semi-structured interviews. Eligibility criteria included geriatric patients ≥70 with CKD 4 or 5 without documented life-sustaining treatment (LST) preferences in the past 90 days. Patients were referred to palliative care (PC) clinic for GOCCs.

Results

62 patients were identified and 40 were enrolled. Most patients preferred in-person and telephone PC visits (70%). Only 30% preferred telehealth.There were no clinical or demographic differences among patients based on visit modality preference, including in LST preferences. In patients who preferred an in-person visit, 42% cited discomfort with technology and 25% cited functional deficits.

Conclusion

Life sustaining treatment preferences and note completion rates among older Veterans with advanced CKD did not vary based on GOCC visit modality. Discomfort with technology was the most common barrier to telehealth. Future studies should focus on how to reduce technology barriers for older Veterans.

Funding

  • Veterans Affairs Support