Improving outcomes for patients with chronic kidney disease.
With the support of a recent $50,000 grant from Kidney, Transplant & Diabetes Research Australia (KTDRA) Dr Shilpa Jesudason and the CNARTS Clinical Research Group are implementing a patient centred research project focused on improving outcomes for people living with chronic kidney disease.
This funding, made possible with your support, will allow Dr Jesudason to bring on board a project officer to develop and lead this translational project. It will also involve a multi-disciplinary team to assess patients at the time of starting dialysis, to understand their experience and ultimately improve their care.
“As a team we tend to do very well in basic science, but a couple of years ago I noticed we needed to develop some patient-centered research that brought together the different parts of our service (medical, nursing and allied health). What do patients need from us, and where are the gaps in current research?” Dr Jesudason said.
“With this new project we want to get a snapshot of our patients’ experiences with end-stage kidney disease. We know dialysis is a difficult time and some people don’t cope that well, but we’ve never had data to tell us exactly where they are not coping to help improve their care. Others cope very well and we want to learn more about that.
“This is why we’ve put together a multi-disciplinary team within our unit that includes clinicians, nursing staff, an occupational therapist, dietitian and a psychologist to assess patients who are at key transition points in their care.”
The key and important transition points Dr Jesudason is referring to are when a patient starts dialysis, when they’re on dialysis and have a kidney transplant, and when they have a failed transplant and return back to dialysis.
“These transition points are absolutely critical and are a time of incredible stress, dislocation, fear and uncertainty for patients. We know it’s a tough time based on years of looking after patients, but we’ve never tried to study what happens to them during this transition. We want to find out at what points do they need help, and where we can intervene to make their experience better.
“Our psychologist will be conducting psychological assessments looking at depression, anxiety, coping skills whilst our dietitian will be concerned with the gastrointestinal symptoms patients experience from being on dialysis and how this effects their experience.
“An occupational therapist will be looking at how frail our patients are physically along with their cognition and function status. We will also be looking at people’s quality of life, and asking patients how they feel about their care.”
Dr Jesudason and the multidisciplinary research team will be assessing patients as soon as they start dialysis and again three, six and 12 months down the track to gain an understanding at each crucial time point about how they are feeling and managing.
With this data, the team can pinpoint where the problems are, with the ultimate aim to develop interventions to improve the care provided to patients in those areas.
“We are trying to look at meaningful outcomes that are relevant to our patients. We want outcomes that are amenable to interventions to ultimately improve their dialysis experience.
“The project officer we will employ thanks to this KTDRA funding will help us to coordinate this whole project, which involves hundreds of patients. Ideally, we would like to see outcomes from this project be imbedded into the improvement of our day to day clinical practice. We want it to be translated into the clinic and for patients as quickly as possible.”