scholarly journals Engaging Stakeholders to Develop a Patient-Centered Research Agenda for Chronic Kidney Disease in Delaware

2016 ◽  
Vol 2 (4) ◽  
pp. 33-33
Author(s):  
Sarahfaye Dolman
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Research Agenda ◽  
Patient Centered

Active Medical Management Without Dialysis for Patients With Advanced Chronic Kidney Disease

2020 ◽  
pp. 136-147
Author(s):  
Kelly Li ◽  
Mark Brown
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Medical Management ◽  
Symptom Management ◽  
Symptom Control ◽  
Shared Decision ◽  
Patient Centered ◽  
Advanced Chronic Kidney Disease ◽  
Centered Care

This chapter outlines the management of patients with advanced chronic kidney disease for whom dialysis may not be beneficial or desired. Active medical management without dialysis should be offered to patients through a shared-decision making process as a viable alternative to dialysis. This is important as patients and families wish to consider not only survival, but also symptom control and QoL in their decision to pursue a dialysis or nondialysis pathway. A multidisciplinary team delivering good quality, active, and patient-centered care that combines chronic kidney disease management with the principles of palliative care can help patients achieve good symptom management and quality of life. Active and early planning for the end-of-life phase facilitates appropriate care for patients in acute and/or unexpected deterioration and helps achieve patient and family goals.

Medical Neighborhood Model for the Care of Chronic Kidney Disease Patients

2016 ◽  
Vol 44 (4) ◽  
pp. 308-315 ◽  
Author(s):  
Zoe G. Smith ◽  
Lynn McNicoll ◽  
Timothy L. Clark ◽  
Andrew J. Cohen ◽  
Antonia L. Ross ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Screening Tool ◽  
Interdisciplinary Team ◽  
Patient Centered Medical Home ◽  
Model Of Care ◽  
Patient Centered ◽  
Ckd Stage ◽  
Baseline Characteristics ◽  
Blue Shield

Background: The patient-centered medical home is a popular model of care, but the patient-centered medical neighborhood (PCMN) is rarely described. We developed a PCMN in an academic practice to improve care for patients with chronic kidney disease (CKD). The purpose of this study is to identify the prevalence of CKD in this practice and describe baseline characteristics, develop an interdisciplinary team-based approach to care and determine cost associated with CKD patients. Methods: Patients with CKD stage 3a with comorbidities through stage 5 were identified. Data collected include demographics, comorbidities and whether patients had a nephrologist. Using a screening tool based on the 2012 Kidney Disease Improving Global Outcomes guidelines, a nurse care manager (NCM) made recommendations about management including indications for referral. A pharmacist reviewed patients' charts and made medication-related recommendations. Blue Cross Blue Shield (BCBS) insurance provided cost data for a subset of patients. Results: A total of 1,255 patients were identified. Half did not have a formal diagnosis of CKD and three-quarters had never seen a nephrologist. Based on the results of the screening tool, the NCM recommended nephrology E-consult or full consult for 85 patients. The subset of BCBS patients had a mean healthcare cost of $1,528.69 per member per month. Conclusions: We implemented a PCMN that allowed for easy identification of a high-risk, high-cost population of CKD patients and optimized their care to reflect guideline-based standards.

scholarly journals MP61-06 CLINICAL AND PATIENT-CENTERED OUTCOMES ASSOCIATED WITH CHRONIC INTERMITTENT CATHETERIZATION IN THE CHRONIC KIDNEY DISEASE IN CHILDREN COHORT STUDY

2017 ◽  
Vol 197 (4S) ◽  
Author(s):  
J Michael Winer ◽  
Matthew Matheson ◽  
Arlene C. Gerson ◽  
Jessica Ming ◽  
Bradley A. Warady ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Intermittent Catheterization ◽  
Patient Centered

scholarly journals Patient-Centered Self-Management in Patients with Chronic Kidney Disease: Challenges and Implications

2020 ◽  
Vol 17 (24) ◽  
pp. 9443
Author(s):  
Chiu-Chu Lin ◽  
Shang-Jyh Hwang
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Self Management ◽  
Future Research ◽  
Primary Study ◽  
Patient Centered ◽  
Positive Effects ◽  
Management Interventions ◽  
Unsuccessful Treatment ◽  
Technology Intervention

This review aims to identify attributes of patient-centered self-management (PCSM) in the current literature and explore its implementation in resolving patient obstacles in chronic kidney disease (CKD) treatment and management. A search of relevant articles and literature on PCSM, integrated care, and challenges of CKD management was conducted. Vital attributes of PCSM and current self-management interventions employed to resolve patient obstacles in CKD management were identified from inclusion studies. Findings affirm that PCSM strategies have positive effects on CKD management, but a lack of quality primary study, and long-term evidence presents the need for further development. Future research should focus on the development of a standardized and universal integrated PCSM model and a uniform system of data collection in the clinical setting. The difficulty of CKD management lies in how it is a comorbid and progressive disease. A pure biomedical approach is inadequate. Our review recommends that an integrated PCSM approach with health literacy and information technology intervention, which unifies and integrates patient education, can address the difficulties that are contributing to unsuccessful treatment outcomes. An integrated PCSM model should be implemented systematically and methodologically into future CKD management and health policies.

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