Edinburgh University, United Kingdom
John Ferns is in his fi nal year of MBChB Medicine at the age of 21 years from Edinburgh University, UK. His interests include patient safety & surgery. He has worked with consultant nephrologists in Edinburgh to improve the patient experience in outpatient departments and better patients’ understanding of CKD. Alongside his degree, he is very active within the Royal College of Surgeons, Edinburgh and is currently serving an internship for a surgical skills company, eoSurgical, developing new products and testing their prototypes.
Aim: Patients can greatly affect their own outcomes by altering their health behaviour and doctors have the ability to educate patients and influence behaviour. Chronic Kidney Disease (CKD) can be difficult to understand and affects patient very differently. This study aims to qualitatively investigate newly diagnosed patients’ understanding of the signs and symptoms of deteriorating kidney function and the modifiable lifestyle changes surrounding this at their first OPD appointment with a nephrologist. It also aims to consider any improvements that can be made around this consultation to maximise its effectiveness. Methodology: A qualitative three part questionnaire was rigorously tested and designed to assess the usefulness of the consultation, establish degree of patient understanding of symptoms of CKD deterioration and awareness of possible lifestyle changes. Part 1 was used immediately before the consultation, Part 2 immediately afterwards and Part 3 was used by telephone three days later, to assess recall. The data was then analysed to identify gaps in patients’ knowledge and used as a basis to brainstorm ideas to improve the effectiveness of the consultation. Results: While nephrologists are doing a good job, patients can generally have a better understanding of signs and symptoms and possible lifestyle changes that can be made to improve their condition. As a result, patients may be less inclined to take preventative measures in dealing with their CKD. Conclusion: This lack of knowledge provides cost-effective opportunities, within Lothian, to inform the patient, leading to improved lifestyle choices that can slow the progression of CKD. Earlier symptom recognition through improved education can lead to earlier presentation and treatment changes, which may improve outcome. These goals can be achieved by using innovative educational tools such as priming patients before their consultation and providing them with further information, such as websites and leaflets.