Is Shared Decision Making a reality for people with kidney disease?LSBU's award-winning Reader in Kidney Care, Dr Nicola Thomas, explores experiences of older people in the Shared Decision Making process in advanced kidney care
Shared Decision Making (SDM) is the conversation that happens between a patient and their health professional to reach a healthcare choice together. The new research project will be a collaborative approach between London South Bank University (LSBU), East Kent Hospitals University NHS Foundation Trust and Barts Health.
People with kidney disease have to make difficult choices when their kidney function reaches 10-15 per cent of normal, such as whether to have dialysis and if so, what type to have and what the side-effects or impact on quality of life may be.
Dr Thomas is co-leading the project which aims to find out from older people who have recently undergone the process of making a dialysis choice, exactly how they came to their decision, the factors that influenced them and how far the decision was shared between them, their family and the clinical staff.
Dr Thomas said: "Dialysis therapy can have a devastating effect on patients and families, and unless a kidney transplant is possible, patients may have to undergo dialysis for the rest of their lives. This research will examine how much of a say patients and their family members have in the decision, and if the current methods of providing a choice are effective."
The project will set up an advisory group of patients and carers who will co-lead the project along with the three researchers. Members of the advisory group will themselves interview thirty patients/carers about their experiences, under the guidance of one of the research team members.
Findings from the project will help understand the experiences of older people in the decision-making process in order to identify how the experience can be improved. If decision aids have been used, then the findings will help clinicians understand how far the decision aids met their needs and inform future strategies for development of similar tools or frameworks. The project is due to complete in 2016.
Dr Thomas was recently awarded the "Lifetime Member Award" by the European Dialysis and Transplant Nurses Association/European Renal Care Association for her outstanding contribution to the Association and the advancement of renal care. She has over thirty years' experience in clinical practice, education, quality improvement and research. Over many years she has undertaken teaching, quality improvement and project work for the NHS, Higher Education and third sector. She has a particular interest in the management of early kidney disease in primary care, especially self-management and Shared Decision Making.