Decision aids give patients with chronic kidney disease hope
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Utilizing decision aids before discussing treatment options gives patients with chronic kidney disease hope and improves patients’ motivation to treat the disease, according to a speaker at the virtual Annual Dialysis Conference.
“I want you to see that a diagnosis of anything scary, including kidney failure is a personal tsunami. This is something that shakes the foundation of your life. It washes away everything that you know, changes all of your perspectives. So, it's a huge emotional blow. That's the piece of medicine that I think U.S. healthcare in general doesn't really do a very good job at,” Dori Schatell, MS, from the Medical Education Institute, said. “If we want to do shared decision making, we have to get past fear.”
“Hope improves health related quality of life and improving health related quality of life predicts hospitalization and death. What that means is that hope is literally a life and death prospect,” Schatell said. “People who are hopeful have better mental functioning. That's an aspect of health-related quality of life.”
Schatell said physicians identify hope as an action their patients can still do while undergoing treatment. For example, if patients enjoy a certain hobby, she said telling them that with treatment they can continue to take part in that hobby. Once patients have hope that they will be able to continue the things they love in life, they will be more willing to learn about their disease, she said. Consequently, a treatment choice can then be made.
Decision aids can be helpful when identifying patient values, and Schatell explained a tool that nephrologists can utilize before having treatment choice conversations.
Created by the Medical Educational Institute, My Life, My Dialysis Choice is a free online tool written at a fifth grade reading level to help patients determine their values and what treatment choices best support those values. After logging onto the website, patients choose three values from a list of lifestyle and health values. The tool will automatically show treatment plans that match the chosen values.
“Matching people's options to their values and their goals matters because that's what hope looks like. And you can help people do this,” Schatell said. “We already did all the heavy lifting and all the matching. All you have to do is give them the tool and help them to use it.”
Schatell plans to release an updated book and online tool called My Kidney Life Plan that accomplishes the same goals as the online My Life, My Dialysis Choices, but is more user-friendly. The free and updated tool includes transplant and comfort care as treatment choices. My Kidney Life Plan will go live in April.
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Schatell D, Kidney Life Plan: An effective tool in making the right decisions. Presented at: Annual Dialysis Conference; March 4-6, 2022 (virtual meeting).
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