An Intervention for Employment Maintenance Among Blue-Collar Workers With End-Stage Renal Disease

Rasgon, Scott; Schwankovsky, Lenore; James-Rogers, Annette; Widrow, Leslie; Glick, Jeffrey; Butts, Edmund

doi:10.1016/s0272-6386(12)70143-9

Cited by 95 publications

(54 citation statements)

References 14 publications

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“…For example, most age-and health-eligible incident and prevalent patients with ESRD in the United States are unemployed. If vocational counseling and CKD education are offered to CKD patients with nonmanagerial jobs, the percent of patients that remain employed during ESRD doubles from 23% to 47% (34). Moreover, less than 40% of incident ESRD patients in the United States have received the recommended frequency of mammography, PAP examinations, and PSA or HbA1c measurements (35).…”

Section: Processes Of Care For the Advanced Chronic Kidney Disease Pamentioning

confidence: 99%

Patterns of Care for Patients with Chronic Kidney Disease in the United States

Owen

2003

Journal of the American Society of Nephrology

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Abstract. The burden of chronic kidney disease can be assessed by multiple criteria that underscore the need for improved detection, treatment, and outcome monitoring. Several process measures for the care of advanced CKD patients are examined herein. Twenty seven and 11% of patients with CKD in National Health and Nutrition Examination Surveys (NHANES) III had BP Ͻ140/90 and 130/85, respectively. In addition to inadequate prescription of antihypertensive drugs, another confounder is poor diagnostic recognition of CKD. Recent surveys of incident Medicare-eligible ESRD patients observed severe anemia in a preponderance of patients; mean and median hematocrit values were 27.7% Ϯ 5.9 and 27.8%, respectively. Only 23 to 28% of these patients were prescribed epoetin alfa. Clinical practice guidelines recommend that Ͻ10% of maintenance hemodialysis patients should be chronically dialyzed using percutaneous catheters. A recent national survey of vascular access types among incident American hemodialysis patients found that 30%, 41%, and 29% were dialyzing through a catheter, prosthetic graft, and autologous fistula, respectively. Tunneled catheters are associated with a 39% annual increased risk of death. Based on pharmacokinetic assumptions about the minimum amount of solute clearance by hemodialysis needed for patient survival in ESRD, a GFR of 10.5 ml/min per 1.73 m 2 is needed. The mean GFR of incident ESRD patients in the United States was 9.5 ml/min per 1.73 m 2 in 2000. In addition to the wide international variability in modality treatment selection, geographic variability exists within the United States; Ͻ7 to Ͼ15% of the prevalent patients are treated by peritoneal dialysis across the country. Despite survival and quality-of-life benefits with transplantation, most eligible recipients in the United States have not been placed on a transplant waiting list 6 mo after beginning dialysis. Last, Ͻ40% of incident ESRD patients in the United States have received the recommended frequency of mammography, PAP examinations, or prostatespecific antigen (PSA) or HbA1c measurements. These deficiencies in care for patients with advanced CKD likely adversely influence the survival of US ESRD patients. Contemporary outcome information supports this contention. CKD patients referred to a nephrologist for the first time within 90 d of the start of dialysis have an approximately 40% to 60% increased risk of death during their first year of renal replacement therapy (RRT). Thirty-five percent of CKD patients are seen within 90 d of receiving RRT. In addition, if fewer than five nephrology visits occur, death risks are increased by 15%. These findings confirm the urgent need for improvement in healthcare delivery for CKD patient in the United States.

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Section: Processes Of Care For the Advanced Chronic Kidney Disease Pamentioning

confidence: 99%

Patterns of Care for Patients with Chronic Kidney Disease in the United States

Owen

2003

Journal of the American Society of Nephrology

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“…However, in one of these, de Buck et al (40) found a significant difference in fatigue between the experimental and control groups in favor of the experimental group. Rasgon et al (42) who studied dialysis patients, known for a low employment rate, found an effect on job maintenance for blue-but not white-collar workers. Allaire and colleagues (39) studied rheumatic diseases and found no difference after one year but a significant difference after two years.…”

Section: Discussionmentioning

confidence: 99%

Effect of job maintenance training program for employees with chronic disease – a randomized controlled trial on self-efficacy, job satisfaction, and fatigue

Varekamp

Verbeek²,

Boer³

et al. 2011

Scand J Work Environ Health

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“…Earlier referral for employment counseling has, in fact, been shown to help people stay connected to the workforce (13). Creating a supportive infrastructure to maintain employment rather than aiming to find new employment might be more effective in enabling patients to remain employed.…”

Section: The Paradox Of Disability Policymentioning

confidence: 99%

“…Early referral for employment counseling has been shown to help people stay connected to the workforce (13,17). If networks show their capacity to successfully implement more extensive counseling, it could become part of a future ESRD Network scope of work.…”

Section: A Policy Proposal To Sustain Employmentmentioning

confidence: 99%

A Matter of Choice

Feder

Nadel

Krishnan³

2016

Clinical Journal of the American Society of Nephrology

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Kidney failure is an overwhelming, life-shattering event, but patients with ESRD do not see themselves as being at the end stage of their lives. On the contrary, patients opting for kidney dialysis are choosing to live. Ideally, then, public policy would support patients' choices about how to live-specifically, the choice to continue working. Many patients with ESRD faced with the limitations of their health status and the demands of their treatment understandably choose to leave their jobs, a choice that is facilitated by the availability of public disability and health insurance. However, other patients who have the desire and opportunity to continue working may not get the guidance and support that can actually make their employment possible. Specifically, current disability and health insurance may fail to provide timely treatment and employment counseling to help patients with ESRD remain in their jobs. We, therefore, propose that the Center for Medicare and Medicaid Services support ESRD Networks to initiate more timely employment and treatment counseling in both the ESRD and the late-stage pre-ESRD setting. Although it is too late to require such counseling in the new network scope of work for 2016-2020, active experimentation in the next few years can lay the groundwork for a subsequent contract.

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An Intervention for Employment Maintenance Among Blue-Collar Workers With End-Stage Renal Disease

Cited by 95 publications

References 14 publications

Patterns of Care for Patients with Chronic Kidney Disease in the United States

Patterns of Care for Patients with Chronic Kidney Disease in the United States

Effect of job maintenance training program for employees with chronic disease – a randomized controlled trial on self-efficacy, job satisfaction, and fatigue

A Matter of Choice

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