AKI survivors identify barriers to patient-centered care
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Following hospital discharge, AKI survivors reported several barriers to self-management such as being unaware of and uneducated about their diagnosis, according to data published in Kidney Medicine.
Further, patients reported feeling concerned about dialysis and how to prevent AKI in the future.
“While there is substantial data on causes and outcomes of AKI, there is limited data on the perceptions of patients themselves with AKI,” Clarissa J. Diamantidis, MD, MHS, an associate professor of medicine in the divisions of general internal medicine and nephrology in the department of population health sciences at Duke University School of Medicine, told Healio. “We sought to better understand the patient voice after an episode of AKI.”
In a qualitative study using semi-structured phone interviews, researchers evaluated 24 patients’ perceived barriers and facilitators to AKI self-management following a hospital-related AKI event. All participants were discharged from Duke University Hospital in Durham, North Carolina, and received $25 upon completion of the telephone interview.
The interviews included open-ended questions focused on patients’ experiences with AKI care and overall AKI self-management. Researchers reviewed the questions with three AKI survivors prior to study initiation to confirm that participants would understand the interview. All interviews took place between May and August 2018, lasting 25 to 60 minutes each.
Among 108 eligible patients, 24 completed the interviews. Analyses revealed five consistent themes:
- patients were unaware of their AKI diagnosis;
- patients lacked information about AKI and how to manage it at home;
- patients identified a lack of understanding about AKI;
- patients were concerned about dialysis; and
- patients wanted to know how to prevent AKI in the future.
“We were surprised about patients’ concerns regarding dialysis,” Diamantidis told Healio. “Reflecting on this, however, it makes sense. Most individuals associate problems with their kidneys to dialysis.”
Limitations of this study includes a population specific to Southeastern United States and potential elevated awareness of AKI in patients. Researchers noted that future studies should include a diverse population.
“We discovered that few patients even knew about their AKI and received limited education about strategies to preserve their kidney health after leaving the hospital,” Diamantidis told Healio. “This may impact the kidney health of those with AKI over their life course, as AKI is a risk factor for long-term events such as recurrent AKI, chronic kidney disease and death.”
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