‘Latinx’ patients pick home dialysis when health literacy, family involvement improves
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BOSTON — Language barriers to educational materials are an issue patients self-identified as “Hispanic/Latinx” face when considering home dialysis, according to a study presented at the National Kidney Foundation Spring Clinical Meetings.
“Latinx people experience a faster progression of chronic kidney disease (CKD) to end-stage kidney disease (ESKD) and a higher incidence of ESKD compared to non-Latinx white individuals but are less likely to do home dialysis,” Katherine Rizzolo, MD, a nephrology fellow at University of Colorado Health, and colleagues wrote. “The motivations and barriers to home therapies for Latinx patients with ESKD has not been elicited.”
Rizzolo said the Latinx population for the study included patients eligible for home dialysis who had an ethnicity of Hispanic/Latinx listed in their medical chart.
For the study, telephone interviews were completed with home dialysis staff, including physicians, educators, nurses, social workers, registered dietitians and technicians at three home dialysis clinics in the Denver metro area. The authors reported they expected a maximum of 40 providers to participate before completion of the survey.
“We were interested in studying the perspectives of dialysis providers taking care of Latinx patients on home dialysis,” Rizzolo told Healio. “Latinx patients are less likely to use home dialysis and while the issue has been studied using large data sets, it has not been well explained based on clinical factors, geographic factors or socioeconomic factors,” Rizzolo said.
Dialysis providers responding to the survey said they all spoke English with patients. Experience in dialysis care ranged from 1 year to 30 years, according to the abstract.
“Motivations for home dialysis [from patients] included the ability to continue working, quality of life and independence, and flexibility with diet,” Rizzolo and colleagues wrote.
However, they identified some obstacles. “Barriers to home dialysis unique to the Latinx community [were] not wanting to be a burden on the family, poor understanding of disease progression, living space challenges, and insurance for undocumented immigrants,” they wrote.
Some of those issues can be resolved. “Frequent meetings with family, dialysis education sessions, Spanish-language resources and an approachable atmosphere were key to including Latinx patients” in decisions about choosing home dialysis, Rizzolo and colleagues wrote.
“Among the clinics that were part of our initial research, the most successful with home dialysis for Latinx patients told us they integrated families into the education,” Rizzolo told Healio. “During the pandemic, only one family member was allowed to participate in the education.
“Latinx families are tightknit; it is important to make them part of the patient care team,” she said.
Other important steps include having a dietitian available who can advise on culturally competent meals. “Patients on home dialysis can eat a wider variety of foods, so having a dietitian who is culturally competent is helpful,” Rizzolo told Healio.
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Rizzolo K, et al. Poster 358. Presented at: National Kidney Foundation Spring Clinical Meetings; April 5-10, 2022; Boston.
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