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Older Patients' Perspectives on Managing Complexity in CKD Self-Management
C Barrett Bowling1,2, Ann E Vandenberg1,2, Lawrence S Phillips2
1Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs, Atlanta Veterans Affairs, Medical Center, Decatur, Georgia; and.
Summary
Managing chronic kidney disease (CKD) is complex for older adults due to multiple health conditions. Integrating care across conditions is key for effective CKD self-management in elderly patients.
Area of Science:
- Gerontology
- Nephrology
- Public Health
Background:
- Chronic kidney disease (CKD) self-management requires adherence to complex regimens.
- Aging impacts functional capacity, potentially making self-management more challenging for older adults.
- Specific challenges older adults face in CKD self-management are not well understood.
Purpose of the Study:
- To explore factors influencing CKD self-management in older adults.
- To understand the relationship between multimorbidity and CKD self-management challenges.
- To identify strategies for improving self-management support in this population.
Main Methods:
- Exploratory qualitative study using six focus groups.
- Participants: 30 veterans aged 70+ with moderate-to-severe CKD.
- Data analysis: Grounded theory with constant comparative method.
Main Results:
- Managing complexity emerged as a central theme.
- Participants often had multiple co-occurring conditions (multimorbidity).
- Discordant treatment recommendations and prioritization/simplification strategies were noted.
Conclusions:
- Multimorbidity significantly challenges CKD self-management in older veterans.
- An integrated treatment approach is crucial for supporting self-management across conditions.
- Addressing multimorbidity is essential for effective CKD care in the elderly.