BACKGROUND: Palliative care for patients with end-stage renal disease (ESRD) is a neglected aspect of nephrology. We carried out this survey to establish the current pattern of provision of palliative care for ESRD in the UK. METHODS: An anonymous but numbered questionnaire concerning local palliative care provision was sent to clinical directors of all 69 UK renal units. RESULTS: All the questionnaires were returned. Only 27 (39%) units employ nursing or Professions Allied to Medicine (PAM) staff with palliative care for ESRD patients as a specified part of their role. In 19 of these units, staff spend <4 h per week concerned with palliative care and only five units have staff working for >12 h a week in this role. Fifty-five (80%) units do not have a written protocol for palliative care. Anaemic ESRD patients with an expected survival of >3 months receive blood transfusion in 59 (86%) units, intravenous iron in 61 (88%) units and erythropoietin in 63 (91%) units. Only 37 (54%) units kept a record of patients seen by the unit staff but deemed not suitable for dialysis. CONCLUSION: There is a significant variation in provision of palliative care services across the UK. In some areas, access to palliative care is restricted to patients with malignant disease, and ESRD patients are excluded.
BACKGROUND: Palliative care for patients with end-stage renal disease (ESRD) is a neglected aspect of nephrology. We carried out this survey to establish the current pattern of provision of palliative care for ESRD in the UK. METHODS: An anonymous but numbered questionnaire concerning local palliative care provision was sent to clinical directors of all 69 UK renal units. RESULTS: All the questionnaires were returned. Only 27 (39%) units employ nursing or Professions Allied to Medicine (PAM) staff with palliative care for ESRDpatients as a specified part of their role. In 19 of these units, staff spend <4 h per week concerned with palliative care and only five units have staff working for >12 h a week in this role. Fifty-five (80%) units do not have a written protocol for palliative care. Anaemic ESRDpatients with an expected survival of >3 months receive blood transfusion in 59 (86%) units, intravenous iron in 61 (88%) units and erythropoietin in 63 (91%) units. Only 37 (54%) units kept a record of patients seen by the unit staff but deemed not suitable for dialysis. CONCLUSION: There is a significant variation in provision of palliative care services across the UK. In some areas, access to palliative care is restricted to patients with malignant disease, and ESRDpatients are excluded.
Authors: Ikumi Okamoto; Sarah Tonkin-Crine; Hugh Rayner; Fliss E M Murtagh; Ken Farrington; Fergus Caskey; Charles Tomson; Fiona Loud; Roger Greenwood; Donal J O'Donoghue; Paul Roderick Journal: Clin J Am Soc Nephrol Date: 2014-11-11 Impact factor: 8.237
Authors: Jake Tobin; Alice Rogers; Isaac Winterburn; Sebastian Tullie; Asanish Kalyanasundaram; Isla Kuhn; Stephen Barclay Journal: BMJ Support Palliat Care Date: 2021-02-19 Impact factor: 4.633
Authors: Emma Wilkinson; Gurch Randhawa; Edwina Brown; Maria Da Silva Gane; John Stoves; Graham Warwick; Tahira Akhtar; Regina Magee; Sue Sharman; Ken Farrington Journal: BMC Palliat Care Date: 2016-07-11 Impact factor: 3.234
Authors: Hannah K S Beckwith; Anamika Adwaney; Maura Appelbe; Helen T Gaffney; Peter Hill; Dihlabelo Moabi; Virginia L Prout; Emma Salisbury; Phil Webster; James A P Tomlinson; Edwina A Brown Journal: Kidney Int Rep Date: 2021-03-03