R. Seymour2, B. Abai1, P. DiMuzio1, M. Nooromid1 1Thomas Jefferson University, Vascular Surgery, Philadelphia, PA, USA 2Washington Hospital Center, Vascular Surgery, Washington, DC, USA
Introduction: Patient education regarding chronic kidney disease, hemodialysis and dialysis access is variable. Unfortunately, without prior exposure to accessible education regarding this medically complex and demanding condition, patients may leave their initial vascular surgery consultation confused and with more questions than answers. Our study seeks to better understand the deficits in patient education regarding chronic kidney disease, hemodialysis, and dialysis access to facilitate the development of an effective educational model that better prepares patients for their dialysis access journey.
Methods: We developed a survey instrument and collected demographic and patient experience data from 22 patients presenting to the vascular surgery clinic for first-time dialysis access evaluation. Patients presenting for dialysis access follow-up were excluded. This study was approved by the Institutional Review Board.
Results: Of the 22 participants, 77.3% identify as Black or African American, 63.6% report high school as the highest level of educational attainment, and 33.3% report earning less than $20,000 in 2022. In total, 45.5% of participants reported that a healthcare professional explained what an arteriovenous (AV) fistula is prior to surgical consultation, but 81.8% and 59.1% of those participants do not feel confident that they can explain what an AV fistula is, or why they may need an AV fistula respectively. 63.6% of participants identify a nephrologist as the healthcare provider who explained AV fistulas. Overall, only 27.3% of participants report that a healthcare professional explained the steps involved in receiving dialysis access.
Conclusion: Overall, many patients presenting to vascular surgery for new AV access creation come from socioeconomically disadvantaged backgrounds with the majority of patients having no higher education. Many participants had an inadequate understanding of the AV access creation process at presentation for surgical consultation, highlighting a need for more effective educational interventions. Additionally, many participants report their nephrologist as the primary source of education, emphasizing an opportunity for interdisciplinary educational outreach.