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Cazzolli R, Sluiter A, Bateman S, Candler H, Cho Y, Cooper T, Craig JC, Dominello A, Duncanson E, Guha C, Hawley CM, Hewawasam E, Hickey L, Hill K, Howard K, Howell M, Huuskes BM, Irish GL, Jesudason S, Johnson DW, Kelly A, Leary D, Manera K, Mazis J, McDonald S, McLennan H, Muthuramalingam S, Pummeroy M, Scholes-Robertson N, Teixeira-Pinto A, Tunnicliffe DJ, van Zwieten A, Viecelli AK, Wong G, Jaure A. Improving Diverse and Equitable Involvement of Patients and Caregivers in Research in CKD: Report of a Better Evidence and Translation-Chronic Kidney Disease (BEAT-CKD) Workshop. Am J Kidney Dis 2024:S0272-6386(24)00784-4. [PMID: 38810688 DOI: 10.1053/j.ajkd.2024.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/21/2024] [Accepted: 03/27/2024] [Indexed: 05/31/2024]
Abstract
Patient and caregiver involvement can enhance the uptake and impact of research, but the involvement of patients and caregivers who are underserved and marginalized is often limited. A better understanding of how to make involvement in research more broadly accessible, supportive, and inclusive for patients with chronic kidney disease (CKD) and caregivers is needed. We conducted a national workshop involving patients, caregivers, clinicians, and researchers from across Australia to identify strategies to increase the diversity of patients and caregivers involved in CKD research. Six themes were identified. Building trust and a sense of safety was considered pivotal to establishing meaningful relationships to support knowledge exchange. Establishing community and connectedness was expected to generate a sense of belonging to motivate involvement. Balancing stakeholder goals, expectations, and responsibilities involved demonstrating commitment and transparency by researchers. Providing adequate resources and support included strategies to minimize the burden of involvement for patients and caregivers. Making research accessible and relatable was about nurturing patient and caregiver interest by appealing to intrinsic motivators. Adapting to patient and caregiver needs and preferences required tailoring the approach for individuals and the target community. Strategies and actions to support these themes may support more diverse and equitable involvement of patients and caregivers in research in CKD.
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Affiliation(s)
- Rosanna Cazzolli
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney.
| | - Amanda Sluiter
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Samantha Bateman
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide; Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide; Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health & Medical Research Institute, Adelaide
| | | | - Yeoungjee Cho
- Australasian Kidney Trials Network, Brisbane; Faculty of Medicine, Brisbane; University of Queensland, and Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane
| | - Tess Cooper
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide
| | - Amanda Dominello
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Emily Duncanson
- Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health & Medical Research Institute, Adelaide
| | - Chandana Guha
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Carmel M Hawley
- Australasian Kidney Trials Network, Brisbane; Faculty of Medicine, Brisbane; University of Queensland, and Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane
| | - Erandi Hewawasam
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide; Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health & Medical Research Institute, Adelaide
| | | | - Kathy Hill
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney
| | | | - Martin Howell
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; Menzies Centre for Health Policy and Economics, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Brooke M Huuskes
- Department of Microbiology, Anatomy, Physiology and Pharmacology, School of Agriculture. Biomedicine and Environment, La Trobe University, Melbourne
| | - Georgina L Irish
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide; Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide
| | - Shilpanjali Jesudason
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide; Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide
| | - David W Johnson
- Australasian Kidney Trials Network, Brisbane; Faculty of Medicine, Brisbane; University of Queensland, and Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane
| | - Ayano Kelly
- University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Diana Leary
- University of Queensland, and Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane
| | - Karine Manera
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Jasmin Mazis
- Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health & Medical Research Institute, Adelaide
| | - Stephen McDonald
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide; Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide; Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health & Medical Research Institute, Adelaide
| | - Helen McLennan
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Shyamsundar Muthuramalingam
- Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health & Medical Research Institute, Adelaide; Central Adelaide Local Health Network, Adelaide
| | | | - Nicole Scholes-Robertson
- University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney; College of Medicine and Public Health, Flinders University, Adelaide
| | - Armando Teixeira-Pinto
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - David J Tunnicliffe
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Anita van Zwieten
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Andrea K Viecelli
- Australasian Kidney Trials Network, Brisbane; Faculty of Medicine, Brisbane; University of Queensland, and Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane
| | - Germaine Wong
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Allison Jaure
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
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Cazzolli R, Sluiter A, Guha C, Huuskes B, Wong G, Craig JC, Jaure A, Scholes-Robertson N. Partnering with patients and caregivers to enrich research and care in kidney disease: values and strategies. Clin Kidney J 2023; 16:i57-i68. [PMID: 37711636 PMCID: PMC10497378 DOI: 10.1093/ckj/sfad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Indexed: 09/16/2023] Open
Abstract
Patient and caregiver involvement broadens the scope of new knowledge generated from research and can enhance the relevance, quality and impact of research on clinical practice and health outcomes. Incorporating the perspectives of people with lived experience of chronic kidney disease (CKD) affords new insights into the design of interventions, study methodology, data analysis and implementation and has value for patients, healthcare professionals and researchers alike. However, patient involvement in CKD research has been limited and data on which to inform best practice is scarce. A number of frameworks have been developed for involving patients and caregivers in research in CKD and in health research more broadly. These frameworks provide an overall conceptual structure to guide the planning and implementation of research partnerships and describe values that are essential and strategies considered best practice when working with diverse stakeholder groups. This article aims to provide a summary of the strategies most widely used to support multistakeholder partnerships, the different ways patients and caregivers can be involved in research and the methods used to amalgamate diverse and at times conflicting points of view.
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Affiliation(s)
- Rosanna Cazzolli
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Amanda Sluiter
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Chandana Guha
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Brooke Huuskes
- Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Melbourne, VIC, Australia
| | - Germaine Wong
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Jonathan C Craig
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Allison Jaure
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Nicole Scholes-Robertson
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
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Abstract
The prevalence of obesity has increased dramatically during the past decades, which has been a major health problem. Since 1975, the number of people with obesity worldwide has nearly tripled. An increasing number of studies find obesity as a driver of chronic kidney disease (CKD) progression, and the mechanisms are complex and include hemodynamic changes, inflammation, oxidative stress, and activation of the renin-angiotensin-aldosterone system (RAAS). Obesity-related kidney disease is characterized by glomerulomegaly, which is often accompanied by localized and segmental glomerulosclerosis lesions. In these patients, the early symptoms are atypical, with microproteinuria being the main clinical manifestation and nephrotic syndrome being rare. Weight loss and RAAS blockers have a protective effect on obesity-related CKD, but even so, a significant proportion of patients eventually progress to end-stage renal disease despite treatment. Thus, it is critical to comprehend the mechanisms underlying obesity-related CKD to create new tactics for slowing or stopping disease progression. In this review, we summarize current knowledge on the mechanisms of obesity-related kidney disease, its pathological changes, and future perspectives on its treatment.
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Affiliation(s)
- Zongmiao Jiang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Yao Wang
- Department of Orthopedics, The Second Hospital Jilin University, Changchun, China
| | - Xue Zhao
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Haiying Cui
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Mingyue Han
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Xinhua Ren
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Xiaokun Gang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Guixia Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
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The Impact of COVID-19 on Patient, Family Member, and Stakeholder Research Engagement: Insights from the PREPARE NOW Study. J Gen Intern Med 2022; 37:64-72. [PMID: 35349019 PMCID: PMC8960674 DOI: 10.1007/s11606-021-07077-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/21/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Little is known about the impact of COVID-19 on patient, family member, and stakeholder patient-centered outcomes research engagement. OBJECTIVE To answer the research questions: (1) What is the impact of COVID-19 on the lives of patients with kidney disease and their families? (2) What is the impact of COVID-19 on research engagement for patient and family member research team members who are themselves at very high risk for poor COVID-19 outcomes? and (3) How can we help patients, family members, and stakeholder team members engage in research during COVID-19? DESIGN We conducted virtual semi-structured interviews with patient and family member co-investigators and kidney disease stakeholders from the PREPARE NOW study during November 2020. The interview guide included questions about participants' experiences with the impact of COVID-19 on research engagement. PARTICIPANTS Seven patient and family member co-investigators and eight kidney disease stakeholders involved in a kidney disease patient-centered outcomes research project participated in the interviews, data analysis, and writing this manuscript. APPROACH We used a content analysis approach and identified the main themes using an inductive process. KEY RESULTS Respondents reported three main ways that COVID-19 has impacted their lives: emotional impact, changing behaviors, and changes in health care delivery. The majority of respondents reported no negative impact of COVID-19 on their ability to engage in this research project. Suggestions for patient-centered outcomes research during COVID-19 and other emergencies include virtual research activities; active engagement; and promoting trust, honesty, transparency, and authenticity. CONCLUSIONS COVID-19 has had a significant negative impact on patient, family member, and stakeholder research team members; however, this has not resulted in less research engagement. TRIAL REGISTRATION Clinicaltrials.gov NCT02722382.
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Guerraoui A, Galland R, Belkahla-Delabruyere F, Didier O, Berger V, Sauvajon P, Serve C, Zuriaga JC, Riquier F, Caillette-Beaudoin A. Design of therapeutic education workshops for home haemodialysis in a patient-centered chronic kidney diseases research: a qualitative study. BMC Nephrol 2022; 23:53. [PMID: 35109808 PMCID: PMC8812054 DOI: 10.1186/s12882-022-02683-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 01/24/2022] [Indexed: 12/02/2022] Open
Abstract
Rationale & Objective A quarter of patients do not receive any information on the modalities of renal remplacement therapy (RRT) before its initiation. In our facility, we provide therapeutic education workshops for all RRT except for home hemodialysis (HHD). The objectives of this study were to identify and describe the needs of CKD patients and caregivers for RRT with HHD and design therapeutic education workshops. Setting & participants Two sequential methods of qualitative data collection were conducted. Interviews with patients treated with HHD and doctors specialized in HHD were performed to define the interview guide followed by semi-structured interviews with the help of HHD patients from our center. Analytic approach Thematic analysis was conducted and were rooted in the principles of qualitative analysis for social scientists. Data were analyzed by two investigators. Transcribed interviews were entered into RQDA 3.6.1 software for data organization and coding purposes (Version 3.6.1). Results In total, five interviews were performed. We identified six themes related to the barriers, facilitators, and potential solutions to home dialysis therapy: (1) HHD allows autonomy and freedom with constraints, (2) safety of the care environment, (3) the caregiver and family environment, (4) patient’s experience and experiential knowledge, (5) self-care experience and impact on life, and (6) factors that impact the choice of treatment with HHD. We designed therapeutic education workshops in a group of patients and caregivers. Conclusions Our study confirmed previous results obtained in literature on the major barriers, facilitators, and potential solutions to HHD including the impact of HHD on the caregiver, the experiences of patients already treated with HHD, and the role of nurses and nephrologists in informing and educating patients. A program to develop patient-to-patient peer mentorship allowing patients to discuss their dialysis experience may be relevant. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-022-02683-0.
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Affiliation(s)
| | - Roula Galland
- Department of Nephrology-Dialysis, Calydial, Lyon, France
| | | | - Odile Didier
- Department of Nephrology-Dialysis, Calydial, Lyon, France
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