Anticoagulation Decisions in Advanced CKD

Facilitating active participation in anticoagulant decisions in advanced kidney disease.

Key Aims:

To co-produce materials to support shared-decision making for anticoagulant use in CKD to be used by clinicians and patients.

People with CKD have higher risks of bleeding episodes than those with standard kidney function. There is a delicate balance between bleeding risk and thrombosis prevention, making anticoagulant treatment decisions challenging. Collaboration and shared decision making should be encouraged as part of patient treatment however, evidence regarding anticoagulation therapy in CKD is limited.

Impact:

Focus groups were undertaken to allow people with lived experience of CKD taking anticoagulants to discuss their experiences with others, encouraging openness and allowing participants to build on each other’s ideas. Through an iterative co-design process with input from patients and healthcare professionals, a Question Prompt List (QPL) was developed. QPLs can aid to reduce the disconnect between patient and prescriber, enabling provision of information that addresses patient priorities and therefore reduces anxiety. The QPL will be incorporated into a national guideline to support shared-decision making discussions.

Project Team and Funding:

This research was supported by the National Institute for Health Research (HEE/ NIHR ICA Programme Clinical Doctoral Research Fellowship, Miss Kathrine Parker)

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