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Kidney disease and the role of video information

HealthPad

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Nephrology

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acute kidney disease

chronic kidney disease

Improving the quality of healthcare usually means significant cost hikes. Acute kidney injury (AKI), however, which kills between 12,000 and 42,000 people in England each year, can be reduced at little cost, and could save the NHS between Â£434 million and Â£620 annually.

Severe dehydration is one of the main causes of AKI. Informing at risk patients of the importance of drinking water could reduce the incidence rate of AKI.

The silent killer
AKI relates to the rapid loss of kidney function. Often it has no symptoms and frequently goes unnoticed by medical staff. AKI's most common in people over 65, and may affect as many as one in six hospital patients who are admitted as an emergency. If left untreated, the condition can result in permanent kidney damage and death.

AKI usually develops before patients enter hospital, and is often caused by dehydration, or an adverse reaction from seriously ill patients to over-the-counter medicines such as ibuprofen. AKI also can develop after some heart surgeries when the kidneys may be deprived of normal blood flow.

Once in hospital, AKI is easily diagnosed by a standard blood or urine test. After diagnosis, the condition can be treated by ensuring that patients stay hydrated or by changing their medications.

Chronic kidney disease (CKD)
Chronic kidney disease (CKD) is a condition in which kidneys are damaged and can't filter blood as well as healthy kidneys. Because of this, wastes from the blood remain in the body and may cause other health problems.

Various chronic diseases have detrimental effects on the kidneys. Rapidly rising global rates of chronic diseases portend a consequent rise in kidney failure and end stage renal disease (ESRD). Over the past two decades, worldwide there has been a 165% increase in dialysis treatments for ESRD.

Despite the magnitude of the resources committed to the treatment of kidney disease and the substantial improvements in the quality of care, kidney patients continue to experience significant rates of mortality and morbidity. Partly, this could be the result of poor delivery of medical information.

Variation in kidney care
The 2013 Kidney Care Atlas provides evidence to support this thesis by describing variations in the healthcare that people in England with kidney disease receive.

Some variation is to be expected because CKD is more common in older people and ethnicity is a strong influence on the pattern and prevalence of kidney disease in communities. Some variation, however, is unwarranted, and the magnitude of variation in some instances is large.

The Quality and Outcomes Framework (QOF)
The Kidney Care Atlas underlines the importance of GPs providing quality healthcare information to patients in formats they prefer. GPs in England are incentivized by the Quality and Outcomes Framework (QOF), which rewards "good practice".

Under the QOF system, doctors are incentivised to establish and maintain a register of patients with CKD and provide them with information about their condition. Ninety per cent of GPs provide such information in leaflets, whereas increasingly patients prefer healthcare information online and in video format.

Data in the Kidney Care Atlas suggests that kidney patients need to be more effectively informed about readily available, inexpensive therapies that can slow and prevent the progression of CKD. This could be achieved by simply substituting videos for leaflets and integrated into the QOF system.

Takeaways
Videos, unlike doctors, never wear out and can be accessed by thousands of patients simultaneously, 24-7, 365 days a year from anywhere, at anytime and on any device. Doctors who use videos to inform patients suggest this relieves pressure on GP surgeries and A&E departments.

Ten short videos could reduce kidney disease by encouraging people at risk of CKD to: