Researchers have developed a tool for patients with advanced chronic kidney disease (CKD) who are often faced with difficult medical choices, such as whether to start dialysis or undergo kidney transplantation. This new tool will help health professionals assess CKD patients' readiness to make important life-changing treatment decisions around their dialysis care.
Investigators developed a tool based on the stage of change algorithm and used it in surveys with 55 CKD patients. 65 percent of patients were in a precontemplation/contemplation (thinking) stage and 35% were in a preparation/maintenance (acting) stage. The researchers found that the algorithm was a useful tool in measuring patients' readiness for dialysis decision-making. Patients who had knowledge about their options and had fewer lifestyle barriers to home dialysis were more likely to make decisions. Also, clinicians who explained the available treatment options helped increase patients' readiness for decision-making.
Study lead, Dr. Suma Prakash said, "Focusing on understanding the decision-making process from patients' perspectives allows us as medical professionals to help patients make timely decision about their options. Some potential impacts of reaching this goal are that patients might opt more for home dialysis options, and more patients may be able to start their preferred option in a non-urgent manner and not require admission to hospital to start dialysis."
This tool is described in a study published in 'Clinical Journal of the American Society of Nephrology'.