Since November, I have been working as a research assistant in the REACH Lab (Research on Ethics, Aging and Community Health) with Dr. Keren Ladin analyzing transcribed interviews of clinicians, patients, and their care partners who are involved in the Decision Aid for Renal Therapy (DART) trial. DART is a web-based aid that helps educate patients with chronic kidney disease (CKD) regarding treatment options. The DART aims to help guide the patient-practitioner decision-making process to facilitate making collaborative choices that involve the patient discussing what seems best for them and their lifestyle goals.
These interviews present so many varying perspectives on CKD and shared decision-making, particularly in the age of COVID-19. The recent emphasis on telehealth has uncovered more disparities in the general population. Ironically, issues of access emerged for many patients who are older, low vision, hard of hearing, or have little access to technology. For family members who would normally attend in-person appointments with their loved ones, they are now no longer allowed in the room due to COVID restrictions. It will be interesting to see if and how this has changed the decision-making process of CKD patients.
Quality of life can decrease while on dialysis (Nephrology News and Issues, January 2021). In some cases of CKD, conservative management, or medical management without dialysis, can be a better treatment option for a patient. However, conservative management requires a multidisciplinary approach to patient care. As I spend more time in these patient narratives, I believe that occupational therapists could be a great fit in a multidisciplinary CKD team as consultants or practitioners because of their holistic lens and concerns about quality of life outcomes.
Overall, my experience in the REACH Lab so far has allowed me to “meet” different patients and clinicians, in a way. I am recognizing their varying backgrounds, cultures, and perspectives on care and treatment. This is strengthening my skills as an Entry Level OTD student during a time where it is difficult or impossible to meet diverse people in the community. Noticing trends while being involved in the DART qualitative study has been fascinating and has added to my understanding of the human condition.
Nephrology News and Issues (January, 2021): https://www.healio.com/news/nephrology/20210112/medical-management-without-dialysis-offers-alternative-therapy