GuidelinesOther guideline
Conclusions
Proposed research agenda (adults and paediatrics) Recommendations Proposed research agenda (adults and paediatrics) Determine the actual number of patients who require palliative and supportive care due to ESKD. This should be accompanied by a needs assessment of the ESKD patient and their families so as to develop a strategic and comprehensive approach to address the unique needs of our country
Proposed research agenda (adults and paediatrics)
Proposed research agenda (adults and paediatrics)
- Determine the actual number of patients who require palliative and supportive care due to ESKD. This should be accompanied by a needs assessment of the ESKD patient and their families so as to develop a strategic and comprehensive approach to address the unique needs of our country within our available resources.
- Study the relevance of internationally recognized communication tools in our South African context.
- Develop prognostic measures for our setting given our unique cultural and ethnic diversity. Further research, especially in resource-limited environments with a high burden of disease, should be encouraged.
- Determine outcomes of effective supportive care in different categories of ESKD patients, whether on dialysis or not.
- Compile a multi-centre symptom inventory (e.g. IPOSRenal) of dialysis patients in both the public and private sectors.
- Aim to understanding the special needs of paediatrics within these frameworks.
Recommendations
- Upskill healthcare workers in essential communication skills.
- Establish the role of medical insurance societies in palliative and supportive care in ESKD.
- Highlight the hidden costs of dialysis that are not often included by some medical insurers.
- Explore better arrangements for the provision of hidden costs, such as packaged care models.
- Acknowledge that multidisciplinary cover should be included in the dialysis costs (for the services of a dietician, psychologist, social worker, access, etc.).
- Basic medical insurance cover:
- When to join?
- What is provided?
- Motivate for all the required medication at primary healthcare level.
- Extend the Essential Drugs List.
- In view of the limited access to RRT, we advocate that renal supportive care should be supported by government.
- Fund renal supportive care nurses and their training.
Wearne, N., Krause, R., Davidson, B., and Brennan, F., 2020. Renal palliative and supportive care in South Africa – A consensus statement. African Journal of Nephrology, 23(1), pp.86-107.