Mrs Natividad Miles1, Mrs Grace Edwards2
1Royal Prince Alfred Hospital, Camperdown, Australia, 2Concord Repatriation General Hospital, Concord, Australia
Biography:
Grace Edwards works at the Concord Repatriation General Hospital.
Abstract:
Background: Patients with advanced chronic kidney disease (CKD) who are older, frail and have multiple comorbidities with poor functional status are increasing in numbers. Patients with advanced CKD with or without dialysis are suffering from high symptom burden and if untreated leads to a decreased quality of life (QoL). Integration of palliative care in CKD care had demonstrated to be effective in addressing the high symptom burden of the CKD population. Renal Supportive Care (RSC) is a nurse-led model of care which has been developed to address the palliative care needs of the CKD population.
Aims: To determine the effectiveness of the integration of palliative care for patients with advanced CKD in the improvement of their overall quality of life.
Methods: Twenty patients with advanced CKD on the dialysis pathway and twenty patients with advanced CKD on the conservative pathway were randomly selected and their QoL data were collected. Comparison between the scores before RSC intervention and at six months were evaluated using descriptive statistics including percent, mean and standard deviation.
Results: Forty patients were randomly selected, divided into two groups, dialysis and conservative. The reported QOL for dialysis patients at initial consult, as measured by means of EQ-5D-5L index value score, was 0.23 (0.27) and 0.23 (0.24) for conservative patients. Mean EQ-VAS (Visual Analog Scale) score for dialysis group was 72.0 and 70.25 for the conservative. At six months, EQ-5D-5L index scores, 0.19 (0.05) for dialysis patients and 0.18 (0.21) and EQ-VAS score was 78.45 and 77.75 respectively.
Conclusion: This study has demonstrated that integrating palliative care approach to renal care made significant improvement in quality of life of patients with end stage kidney disease. This pilot highlights the need for further study using larger samples to make a valid claim on the effectiveness of the program.