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Multicenter Study
. 2025 Mar;38(2):687-695.
doi: 10.1007/s40620-024-02193-2. Epub 2025 Jan 27.

A period prevalence study of palliative care need and provision in adult patients attending hospital-based dialysis units

Alannah L Cooper  1   2 , Natalie Panizza  3 , Rebecca Bartlett  3 , Dipna Martin-Robins  3 , Janie A Brown  4   5   6
Affiliations
Multicenter Study

A period prevalence study of palliative care need and provision in adult patients attending hospital-based dialysis units

Alannah L Cooper et al. J Nephrol. 2025 Mar.

Abstract

Background: Advanced chronic kidney disease is a life-limiting disease that is known to benefit from palliative care. Unmet palliative care need in patients with kidney failure is commonly reported but the level of need among patients receiving haemodialysis is unknown.

Methods: A period prevalence study of adult patients attending two hospital-based dialysis units was conducted. Patient medical records were reviewed using the Gold Standards Framework Proactive Indication Guidance to assess for potential palliative care need.

Results: A total of 128 patient medical records were reviewed, 45% (n = 58) of patients could have potentially benefitted from palliative care. Of the patients with indicators for palliative care, 72% (n = 42) had no evidence of receiving or awaiting any form of palliative care. High levels of palliative care need were found in patients who identified as Aboriginal or Torres Strait Islander and non-Indigenous patients.

Conclusions: This study found high levels of palliative care need among adult patients attending hospital-based dialysis units. The majority of patients with indicators were not receiving any form of palliative care.

Keywords: Haemodialysis; Kidney disease; Life-limiting illness; Palliative care.

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Conflict of interest statement

Declarations. Conflict of interests: None to declare. Ethical approval: An application to undertake this research was submitted to the Royal Perth Hospital Human Research Ethics Committee. Approval was sought and gained (5782) to conduct a point prevalence study with a waiver of consent to audit patient medical records. Reciprocal approval for the study was obtained from Curtin University (HRE2023-0339). Informed consent to participate: Data were collected directly from patient medical records under a waiver of consent.

Figures

Fig. 1
Fig. 1
Prevalence of conditions listed in the Gold Standards Framework
Fig. 2
Fig. 2
Prevalence of conditions with sufficient indicators of potential palliative care need
Fig. 3
Fig. 3
Prevalence of palliative care need and provision of palliative care in patients with indicators of potential palliative care need
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