Dialysis Patient Experiences During the COVID-19 Pandemic: A Survey Study

Noce, Elyssa M.; Brereton, Laura; Zorzanello, Mary; Aklilu, Abinet; Anders, Elizabeth; Bernal, Mónica Ramírez; Sundararajan, Anusha; Kodali, Ravi; Patel, Dipal

doi:10.1016/j.xkme.2023.100673

Cited by 4 publications

(2 citation statements)

References 28 publications

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“…41 Most recently, broad restrictions on public transit services along with disruptions to care during the coronavirus disease 2019 pandemic led to longer travel and wait times among patients receiving in-center hemodialysis. [43][44][45] One change that may persist beyond pandemic times is increased partnerships with rideshare and ride-hailing companies for rides to various medical services. To ease the burden of transportation for beneficiaries, Medicaid programs in at least three states also lifted restrictions on partnering with rideshare companies for NEMT during the pandemic.…”

Section: Innovative and Local Solutionsmentioning

confidence: 99%

The Complex Patchwork of Transportation for In-Center Hemodialysis

Tian,

Hall,

Griffin

et al. 2023

JASN

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Reliable transportation is an important determinant of access to health care and health outcomes that carries particular significance for people with end-stage kidney disease (ESKD). In the US, there are almost half a million patients receiving treatment with in-center dialysis, translating into more than 70 million roundtrips to dialysis centers annually. Difficulty with transportation can interfere with patients’ quality of life and contribute to missed or shortened dialysis treatments, increasing their risk for hospitalization. Medicare, the principal payer for dialysis in this country, has not traditionally provided coverage for non-emergency medical transportation (NEMT), placing the burden of travelling to and from the dialysis center on patients and families and a range of other private and public entities that were not designed, and are poorly equipped for this purpose. Here, we review the relationship between access to reliable transportation and health outcomes such as missed and shortened dialysis treatments, hospitalizations, and quality of life. We also describe current approaches to the delivery of transportation for patients receiving in-center hemodialysis, highlighting potential opportunities for improvement.

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Section: Innovative and Local Solutionsmentioning

confidence: 99%

The Complex Patchwork of Transportation for In-Center Hemodialysis

Tian,

Hall,

Griffin

et al. 2023

JASN

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“… 4 Among US patients with ESRD on chronic dialysis, a substantial proportion experienced difficulties with transportation, medication access, and maintenance of diet during the pandemic. 5 Additionally, older patients were more likely to have their care disrupted, despite these patients typically needing a higher level of chronic disease management. 6 More than 40% of chronic disease patients reported their healthcare services were moderately impacted and about one third reported difficulty acquiring their prescribed medications because of the pandemic.…”

Section: Introductionmentioning

confidence: 99%

Characterizing the Impact of the Covid-19 Pandemic on Adults with Autosomal Dominant Polycystic Kidney Disease: A Cross-Sectional Study

Shetty,

Atalla,

Diggs

et al. 2024

Preprint

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Background The Covid-19 pandemic greatly affected those with chronic diseases, impacting healthcare access and healthcare seeking behaviors. The impact of the pandemic on adults with Autosomal Dominant Polycystic Kidney Disease (ADPKD) has not been investigated. Methods Participants were recruited from a cohort of 239 ADPKD patients enrolled in a longitudinal study at the University of Maryland. Patients on renal replacement therapy were excluded. N = 66 patients participated in a phone questionnaire from June 2022-December 2022 about ADPKD-related complications, concern about contracting Covid-19, healthcare-seeking behaviors, and telehealth utilization before and after March 2020. Results N = 34 (51.5%) of participants reported a positive Covid-19 test result and N = 29 (44%) expressed high concern of contracting Covid-19. Those who avoided medical care at least once (N = 17, 25.8%) had similar demographics and ADPKD severity to those who did not, but reported greater telehealth utilization (88.2% vs. 42.9%, p = 0.002), greater use of non-prescribed medication for Covid-19 treatment or prevention (35.3% vs. 8.2%, p = 0.01), and were more likely to contract Covid-19 (76.5% vs. 42.9%, p = 0.02). Among the N = 53 who reported very good or excellent ADPKD disease management pre-pandemic, N = 47(89%) reported no significant change during the pandemic. Conclusions In this highly educated, high-income cohort with a mean age of 46.1 years, most people reported well-managed ADPKD prior to the pandemic. This may explain why less than half of participants expressed high concern for contracting Covid-19. Overall, there was no significant pandemic-related decline in self-reported ADPKD management, like due to excellent access to, and uptake of, telehealth services. Notably, 1 in 4 participants reported healthcare avoidant behavior, the effect of which may only be seen years from now. Future studies should investigate potential impacts of avoidant behaviors, as well as expand investigation to a more diverse cohort whose care may not have been as easily transitioned to telehealth.

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