A national survey of current rehabilitation service provisions for people living with chronic kidney disease in the UK: implications for policy and practice.

Publication date: Sep 12, 2024

National guidance recognises the key role of rehabilitation in improving outcomes for people living with chronic kidney disease. Implementation of this guidance is reliant upon an adequate and skilled rehabilitation workforce. Data relating to this is currently lacking within the UK. This survey aimed to identify variations and good practices in kidney physiotherapy (PT), occupational therapy (OT) and clinical exercise physiologist (CEP) provision; and to understand barriers to implementation. An online survey was sent to all 87 UK kidney units between June 2022 and January 2023. Data was collected on the provision of therapy services, barriers to service provision and responses to the COVID-19 pandemic. The quantitative survey was analysed using descriptive statistics. Free-text responses were explored using reflexive thematic analysis. Forty-five units (52%) responded. Seventeen (38%) units reported having a PT and 15 (33%) an OT with a specialist kidney role; one unit (7%) had access to a CEP. Thirty units (67%) offered inpatient therapy services, ten (22%) outpatient therapy clinics, six (13%) intradialytic exercise, six (13%) symptom management and three (7%) outpatient rehabilitation. Qualitative data revealed lack of money/funding and time (both nā€‰=ā€‰35, 85% and nā€‰=ā€‰34, 83% respectively) were the main barriers to delivering kidney-specific therapy. Responders saw an increase in the complexity of their caseload, a reduction in staffing levels and consequently, service provision during the COVID-19 pandemic. Exemplars of innovative service delivery, including hybrid digital and remote services, were viewed as positive responses to the COVID-19 pandemic. Despite clear evidence of the benefits of rehabilitation, across the UK, there remains limited and variable access to kidney-specific therapy services. Equitable access to kidney-specific rehabilitation services is urgently required to support people to ‘live well’ with kidney disease.

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Concepts Keywords
Clinics Allied health professional
January Chronic kidney disease
June Clinical exercise physiologist
Kidney Exercise
Outpatient Occupational therapy
Physiotherapy
Rehabilitation
Well-being
Workforce

Semantics

Type Source Name
disease MESH chronic kidney disease
disease IDO role
disease MESH COVID-19 pandemic
drug DRUGBANK Pentaerythritol tetranitrate
disease IDO symptom
disease MESH kidney disease
pathway REACTOME Reproduction
disease MESH frailty
disease MESH symptom burden
disease MESH anxiety
disease MESH depression
disease MESH cognitive decline
drug DRUGBANK Trestolone
disease IDO blood
drug DRUGBANK Oxygen
disease MESH restless legs
disease MESH tic
disease IDO intervention
drug DRUGBANK Etoperidone
drug DRUGBANK Huperzine B
drug DRUGBANK Albendazole
drug DRUGBANK Isoxaflutole
drug DRUGBANK Tricyclazole
drug DRUGBANK Ranitidine
disease MESH lifestyle
disease MESH breathlessness
disease MESH acute kidney injury
drug DRUGBANK Spinosad
drug DRUGBANK Serine
disease MESH Stroke
drug DRUGBANK Gold
disease IDO process
disease MESH ESRD
disease MESH Functional status
drug DRUGBANK Hexachlorophene
drug DRUGBANK (S)-Des-Me-Ampa
disease MESH multiple chronic conditions
disease MESH Dementia
drug DRUGBANK Serine Vanadate
drug DRUGBANK Coenzyme M
drug DRUGBANK L-Tyrosine
disease MESH noncommunicable diseases

Original Article

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