Background:

Chronic kidney disease (CKD) referrals continue to increase, with many patients being from remote communities. This can require travel over long distances and extended stays in Alice Springs to attend appointments. Often resulting in poor attendance or significant stress; with family support not being available for life-changing decisions regarding prevention and treatment options. Our aim was to provide a more culturally appropriate and patient-centred approach to service delivery.

Methods:

In 2013, telehealth CKD Clinics were introduced in Ti Tree. The Nephrologist teleconferenced from Alice Springs with the patient, family, DMO and PCD Coordinator in the community. The CKD Coordinator and Renal Dietitian travelled to Ti Tree to conduct concurrent education sessions with the patients, family and primary health care staff.

Results/Discussions:

On average the Flynn Drive CKD clinics have a 48.5% attendance rate, with several patients not attending on more than one occasion. When patients do not attend their clinic appointments they do not receive the necessary information and education to make informed life changing choices.
CKD clinics at the patient’s primary health setting have proven to have better attendance rates, achieving up to 61% attendance. By providing clinics on remote communities, patients have an improved opportunity to access health care and slow the progression of their disease. This approach involves primary health care providers, but more importantly the families of the patients and the wider community.

Conclusions/implications:

Providing health care closer to home allows patients to have meaningful access and interaction with health care providers, improve attendance rates and ultimately result in better patient outcomes. Community members become involved in discussions, increasing their knowledge of CKD, risk factors and how to slow progression of the disease. This knowledge then filters through the community and can instigate change.