Abstract: FR-PO080
Defining Key Elements of Communication after AKI: A Modified Delphi Process by the AKINow Workgroup
Session Information
- AKI: Epidemiology, Risk Factors, and Prevention - 2
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Kwong, Yuenting Diana, UCSF Medical Center, San Francisco, California, United States
- Silver, Samuel A., Queen's University, Kingston, Ontario, Canada
- Neyra, Javier A., The University of Alabama at Birmingham, Birmingham, Alabama, United States
- McCoy, Ian Ellis, UCSF Medical Center, San Francisco, California, United States
- Ng, Jia Hwei, Northwell Health, New Hyde Park, New York, United States
- Abdel-Rahman, Emaad M., University of Virginia, Charlottesville, Virginia, United States
- Gewin, Leslie S., Washington University in St Louis, St Louis, Missouri, United States
- Barreto, Erin F., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Freshly, Bonnie L., American Society of Nephrology, Washington, District of Columbia, United States
- Vijayan, Anitha, Intermountain Medical Center, Murray, Utah, United States
Background
Lack of consensus exists on the key elements of communication about an AKI event between inpatient and outpatient care teams and the information that should be provided to patients and their care partners. We aim to develop and refine standardized communication tools that promote AKI awareness and management based on consensus stakeholder feedback.
Methods
We conducted the first of three semi-structured sessions using the modified Delphi process. We recruited stakeholders through purposive and snowball sampling and surveyed them on a 5-point Likert scale (1-strongly disagree to 5-strongly agree) the population that should receive AKI education and the key elements of post-AKI communication. We then conducted virtual discussions to gather additional insights.
Results
The first session had 36 stakeholders from 7 countries, including 22 physicians (18 nephrologists), 4 nurses, 3 pharmacists, 2 physician assistants, 1 physical therapist, 3 patients with history of AKI, and 1 caregiver. The stakeholders strongly agreed (median rating 5) that AKI education should be provided to patients with AKI stage 2-3, AKI requiring dialysis (AKI-D), AKI with only partial recovery by discharge, and AKI in the setting of CKD stage 3-5. On communication between inpatient and outpatient care teams, the most strongly agreed upon elements were medications to be resumed (94%), baseline creatinine (88%) and discharge creatinine (85%). For patients on dialysis, last dialysis date (94%) and dialysis initiation date (91%) were important. On communication between care teams and AKI survivors, the most strongly agreed upon elements were medication changes (91%) and nephrotoxins to avoid (91%). For patients on dialysis, dialysis appointment (94%), AKI-D education (88%), and catheter care (85%) were important. Qualitative evaluation showed the need to further define who provides post-AKI education and care, preferred communication methods and timing, and actionable guidance on managing post AKI sequelae, especially medications and diet.
Conclusion
In the first of three sessions, stakeholders showed consensus on many key elements of AKI communication for care teams and patients. Subsequent sessions will refine standardized communication tools for clinical use.
Funding
- NIDDK Support