Skip to main content
Erschienen in: International Urology and Nephrology 12/2020

01.08.2020 | Nephrology - Original Paper

Healthcare professionals’ perceptions of the role of a multidisciplinary approach in improving the care of patients with advanced chronic kidney disease

verfasst von: Jia Liang Kwek, Konstadina Griva, Navreen Kaur, Lester Yousheng Lai, Jason Chon Jun Choo, Su Hooi Teo, Lydia Wei Wei Lim, Marjorie Wai Yin Foo, Tazeen Hasan Jafar

Erschienen in: International Urology and Nephrology | Ausgabe 12/2020

Einloggen, um Zugang zu erhalten

Abstract

Objective

To explore and understand the experiences of healthcare professionals (HCPs) delivering care in a multidisciplinary care (MDC) clinic for advanced chronic kidney disease (CKD) patients.

Methods

This is a qualitative study based on semi-quantitative questionnaire and semi-structured interviews with thematic analysis and deductive mapping onto the Theoretical Framework of Acceptability. Sixteen HCPs caring for advanced CKD patients in a MDC clinic in a tertiary teaching hospital in Singapore were recruited based on maximum variation sampling procedures.

Results

The majority of the HCPs were supportive of a MDC clinic. There was a positive overall opinion of the programme [median 7.0 of 10.0 (IQR 7.0–8.0)], high satisfaction ratings for interaction with other members of team [6.9 (5.3–8.0)] and time spent with patients [7.0 (5.3–7.0)]. Thematic analysis of the interviews identified the value of MDC clinic in the provision of one-stop care, the improvement in communication and collaboration between HCPs, the facilitation of patient activation to make planned kidney care decisions, and the optimisation of medications. The main challenges were lack of continuity of care, manpower constraints, poor patient navigation between HCPs, poor patient attendance with allied HCPs, and the perception of increased cost and time spent by patients in each MDC clinic visit. The proposed interventions were notification of patients beforehand of the MDC clinic schedule and provision of navigation to patients within the MDC clinic.

Conclusion

A multidisciplinary care clinic for advanced chronic kidney disease patients was viewed positively by the majority of the healthcare professionals, with areas for improvement.
Literatur
1.
Zurück zum Zitat Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS, Hobbs FD (2016) Global prevalence of chronic kidney disease: a systematic review and meta-analysis. PLoS ONE 11(7):e0158765CrossRef Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS, Hobbs FD (2016) Global prevalence of chronic kidney disease: a systematic review and meta-analysis. PLoS ONE 11(7):e0158765CrossRef
2.
Zurück zum Zitat Sabanayagam C, Lim SC, Wong TY, Lee J, Shankar A, Tai ES (2010) Ethnic disparities in prevalence and impact of risk factors of chronic kidney disease. Nephrol Dial Transpl 25(8):2564–2570CrossRef Sabanayagam C, Lim SC, Wong TY, Lee J, Shankar A, Tai ES (2010) Ethnic disparities in prevalence and impact of risk factors of chronic kidney disease. Nephrol Dial Transpl 25(8):2564–2570CrossRef
3.
Zurück zum Zitat Wong LY, Liew AST, Weng WT, Lim CK, Vathsala A, Toh MPHS (2018) Projecting the Burden of Chronic Kidney Disease in a Developed Country and Its Implications on Public Health. Int J Nephrol 4(2018):5196285 Wong LY, Liew AST, Weng WT, Lim CK, Vathsala A, Toh MPHS (2018) Projecting the Burden of Chronic Kidney Disease in a Developed Country and Its Implications on Public Health. Int J Nephrol 4(2018):5196285
4.
Zurück zum Zitat Keith DS, Nichols GA, Gullion CM, Brown JB, Smith DH (2004) Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization. Arch Intern Med 164(6):659–663CrossRef Keith DS, Nichols GA, Gullion CM, Brown JB, Smith DH (2004) Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization. Arch Intern Med 164(6):659–663CrossRef
5.
Zurück zum Zitat Metcalfe W, Khan IH, Prescott GJ, Simpson K, MacLeod AM (2000) Can we improve early mortality in patients receiving renal replacement therapy? Kidney Int 57(6):2539–2545CrossRef Metcalfe W, Khan IH, Prescott GJ, Simpson K, MacLeod AM (2000) Can we improve early mortality in patients receiving renal replacement therapy? Kidney Int 57(6):2539–2545CrossRef
7.
Zurück zum Zitat Teo BW, Ma V, Xu H, Li J, Lee EJ (2010) Nephrology Clinical Research Group. Profile of hospitalisation and death in the first year after diagnosis of end-stage renal disease in a multi-ethnic Asian population. Ann Acad Med Singapore 39(2):79–87PubMed Teo BW, Ma V, Xu H, Li J, Lee EJ (2010) Nephrology Clinical Research Group. Profile of hospitalisation and death in the first year after diagnosis of end-stage renal disease in a multi-ethnic Asian population. Ann Acad Med Singapore 39(2):79–87PubMed
8.
Zurück zum Zitat Roy D, Chowdhury AR, Pande S, Kam JW (2017) Evaluation of unplanned dialysis as a predictor of mortality in elderly dialysis patients: a retrospective data analysis. BMC Nephrol 18(1):364CrossRef Roy D, Chowdhury AR, Pande S, Kam JW (2017) Evaluation of unplanned dialysis as a predictor of mortality in elderly dialysis patients: a retrospective data analysis. BMC Nephrol 18(1):364CrossRef
9.
Zurück zum Zitat Yap HY, Pang SC, Tan CS, Tan YL, Goh N, Achudan S, Lee KG, Tan RY, Choong LH, Chong TT (2018) Catheter-related complications and survival among incident hemodialysis patients in Singapore. J Vasc Access 19(6):602–608CrossRef Yap HY, Pang SC, Tan CS, Tan YL, Goh N, Achudan S, Lee KG, Tan RY, Choong LH, Chong TT (2018) Catheter-related complications and survival among incident hemodialysis patients in Singapore. J Vasc Access 19(6):602–608CrossRef
10.
Zurück zum Zitat Wei SY, Chang YY, Mau LW, Lin MY, Chiu HC, Tsai JC, Huang CJ, Chen HC, Hwang SJ (2010) Chronic kidney disease care program improves quality of pre-end-stage renal disease care and reduces medical costs. Nephrology 15:108–115CrossRef Wei SY, Chang YY, Mau LW, Lin MY, Chiu HC, Tsai JC, Huang CJ, Chen HC, Hwang SJ (2010) Chronic kidney disease care program improves quality of pre-end-stage renal disease care and reduces medical costs. Nephrology 15:108–115CrossRef
11.
Zurück zum Zitat Curtis BM, Ravani P, Malberti F, Kennett F, Taylor PA, Djurdjev O, Levin A (2005) The short- and long-term impact of multidisciplinary clinics in addition to standard nephrology care on patient outcomes. Nephrol Dial Transpl 20:147–154CrossRef Curtis BM, Ravani P, Malberti F, Kennett F, Taylor PA, Djurdjev O, Levin A (2005) The short- and long-term impact of multidisciplinary clinics in addition to standard nephrology care on patient outcomes. Nephrol Dial Transpl 20:147–154CrossRef
12.
Zurück zum Zitat Chen PM, Lai TS, Chen PY, Lai CF, Yang SY, Wu V, Chiang CK, Kao TW, Huang JW, Chiang WC, Lin SL, Hung KY, Chen YM, Chu TS, Wu MS, Wu KD, Tsai TJ (2015) Multidisciplinary care program for advanced chronic kidney disease: reduces renal replacement and medical costs. Am J Med 128:68–76CrossRef Chen PM, Lai TS, Chen PY, Lai CF, Yang SY, Wu V, Chiang CK, Kao TW, Huang JW, Chiang WC, Lin SL, Hung KY, Chen YM, Chu TS, Wu MS, Wu KD, Tsai TJ (2015) Multidisciplinary care program for advanced chronic kidney disease: reduces renal replacement and medical costs. Am J Med 128:68–76CrossRef
13.
Zurück zum Zitat Wang SM, Hsiao LC, Ting IW, Yu TM, Liang CC, Kuo HL, Chang CT, Liu JH, Chou CY, Huang CC (2015) Multidisciplinary care in patients with chronic kidney disease: a systematic review and meta-analysis. Eur J Intern Med 26(8):640–645CrossRef Wang SM, Hsiao LC, Ting IW, Yu TM, Liang CC, Kuo HL, Chang CT, Liu JH, Chou CY, Huang CC (2015) Multidisciplinary care in patients with chronic kidney disease: a systematic review and meta-analysis. Eur J Intern Med 26(8):640–645CrossRef
14.
Zurück zum Zitat Shi Y, Xiong J, Chen Y, Deng J, Peng H, Zhao J, He J (2018) The effectiveness of multidisciplinary care models for patients with chronic kidney disease: a systematic review and meta-analysis. Int Urol Nephrol 50(2):301–312CrossRef Shi Y, Xiong J, Chen Y, Deng J, Peng H, Zhao J, He J (2018) The effectiveness of multidisciplinary care models for patients with chronic kidney disease: a systematic review and meta-analysis. Int Urol Nephrol 50(2):301–312CrossRef
16.
Zurück zum Zitat Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3:77–101CrossRef Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3:77–101CrossRef
17.
Zurück zum Zitat Sekhon M, Cartwright M, Francis JJ (2017) Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Services Res 17(1):88CrossRef Sekhon M, Cartwright M, Francis JJ (2017) Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Services Res 17(1):88CrossRef
18.
Zurück zum Zitat Tong A, Sainsbury P, Craig J (2007) Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 19:349–357CrossRef Tong A, Sainsbury P, Craig J (2007) Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 19:349–357CrossRef
19.
Zurück zum Zitat Mendelssohn DC, Toffelmire EB, Levin A (2006) Attitudes of Canadian Nephrologists Toward Multidisciplinary Team-Based CKD Clinic Care. Am J Kidney Dis 47(2):277–284CrossRef Mendelssohn DC, Toffelmire EB, Levin A (2006) Attitudes of Canadian Nephrologists Toward Multidisciplinary Team-Based CKD Clinic Care. Am J Kidney Dis 47(2):277–284CrossRef
20.
Zurück zum Zitat Sioutal N, Clement P, Aertgeerts B, Beek K, Menten J (2018) Professionals’ perceptions and current practices of integrated palliative care in chronic heart failure and chronic obstructive pulmonary disease: a qualitative study in Belgium. BMC Palliative Care 17:103CrossRef Sioutal N, Clement P, Aertgeerts B, Beek K, Menten J (2018) Professionals’ perceptions and current practices of integrated palliative care in chronic heart failure and chronic obstructive pulmonary disease: a qualitative study in Belgium. BMC Palliative Care 17:103CrossRef
21.
Zurück zum Zitat Raaijmaker LG, Hamers FJ, Martens MK, Bagchus C, de Vries NK, Kremers SP (2013) Perceived facilitators and barriers in diabetes care: a qualitative study among health care professionals in the Netherlands. BMC Family Pract 14:114CrossRef Raaijmaker LG, Hamers FJ, Martens MK, Bagchus C, de Vries NK, Kremers SP (2013) Perceived facilitators and barriers in diabetes care: a qualitative study among health care professionals in the Netherlands. BMC Family Pract 14:114CrossRef
22.
Zurück zum Zitat Hofstede SN, Marang-van de Mheen PJ, Wentink MM, Stiggelbout AM, Vleggeert-Lankamp CL, Vliet Vlieland TP, van Bodegom-Vos L (2013) Barriers and facilitators to implement shared decision making in multidisciplinary sciatica care: a qualitative study. Implement Sci 8:95CrossRef Hofstede SN, Marang-van de Mheen PJ, Wentink MM, Stiggelbout AM, Vleggeert-Lankamp CL, Vliet Vlieland TP, van Bodegom-Vos L (2013) Barriers and facilitators to implement shared decision making in multidisciplinary sciatica care: a qualitative study. Implement Sci 8:95CrossRef
Metadaten
Titel
Healthcare professionals’ perceptions of the role of a multidisciplinary approach in improving the care of patients with advanced chronic kidney disease
verfasst von
Jia Liang Kwek
Konstadina Griva
Navreen Kaur
Lester Yousheng Lai
Jason Chon Jun Choo
Su Hooi Teo
Lydia Wei Wei Lim
Marjorie Wai Yin Foo
Tazeen Hasan Jafar
Publikationsdatum
01.08.2020
Verlag
Springer Netherlands
Erschienen in
International Urology and Nephrology / Ausgabe 12/2020
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-020-02571-2

Weitere Artikel der Ausgabe 12/2020

International Urology and Nephrology 12/2020 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.