Newswise — Pain is undertreated in three-quarters of dialysis patients and a recent survey reveals why. Only one-third of surveyed second year nephrology fellows indicated receiving training on how to treat pain in dialysis patients and when and how to address end-of-life issues with patients.
Palliative care is now recognized as an important part of the comprehensive care of patients with serious illness. The American Board of Internal Medicine recently acknowledged palliative medicine as a board-certifiable subspecialty. Palliative care is defined as patient and family-centered care that concentrates on reducing the severity of disease symptoms, addressing pyschosocial issues, and optimizing choices throughout a patient’s illness. It is offered simultaneously with all other appropriate medical therapy.
Tod Ibrahim, Executive Director of the American Society of Nephrology recently interviewed Alvin H. Moss, MD, FAAHPM of West Virginia University School of Medicine (Morgantown, WV) and Mark A. Swidler of Mount Sinai School of Medicine (New York, NY) to discuss the topic of palliative care for an ASN podcast.
“Good palliative medicine and geriatric principles provide a systematic way to deliver excellent renal care and simultaneously address quality of life and humanistic concerns no matter what treatment plan the patient is undergoing,” said Dr. Swidler. “It also allows patients and families to be more in control of their care, which creates hope and better prepares patients and their families for the future.”
Dr. Moss explains, “We want nephrologists to better understand that a palliative care approach to dialysis patients can relieve patient pain and suffering and assist in identifying and respecting their goals for care. We also want to let our colleagues know about new research that is available to nephrologists to more accurately predict dialysis patients’ prognosis and to allow timely referral to hospice.”
Dr. Moss and Dr. Swidler stress the importance of an interdisciplinary approach to palliative care. In addition to physicians, nurse practitioners, physician assistants, social workers, dieticians, pastoral care workers, physical therapists, and occupational therapists should all be part of the effort to reduce pain and increase the quality of life for patients suffering from end stage renal disease.
The podcast also provides useful resources on palliative care to nephrologists and other physicians, including websites, such as http://kidneyeol.org/ (Kidney End-of-Life Coalition) and http://www.eperc.mcw.edu/ (End of Life/Palliative Education Resource Center- EPERC); as well as organizations like The National Hospice and Palliative Care Organization (http://www.nhpco.org) and The Center to Advance Palliative Care- CAPC (http://www.capc.org/), which provide educational opportunities and additional resources.
ASN continues to lead the fight against kidney disease by highlighting complex areas of interest, such as palliative care and quality of life issues.
The conversation will be available via podcast through ASN’s website at http://asn-online.org/publications/kidneynews/podcast.aspx and available on iTunes on Monday, October 12, 2009 (ASN Kidney News Podcast).
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Founded in 1966, the American Society of Nephrology (ASN) is the world’s largest professional society devoted to the study of kidney disease. Comprised of 11,000 physicians and scientists, ASN continues to promote expert patient care, advance medical research, and educate the renal community. ASN also informs policymakers about issues of importance to kidney doctors and their patients. ASN funds research, and through its world-renowned meetings and first-class publications, disseminates information and educational tools that empower physicians.
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