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How to Leverage Implementation Science to Achieve Equity in Nephrology Care Delivery
Yuvaram N V Reddy1, Laura Ellen Ashcraft2, Mallika L Mendu3
1Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania; Renal-Electrolyte and Hypertension DivisionUniversity of Pennsylvania, Philadelphia, Pennsylvania; Perelman School of Medicine, and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania.
Abstract:
There are several evidence-based practices within nephrology that have the potential to meaningfully improve patient outcomes and mitigate disparities. However, these practices are inconsistently implemented in routine care, contributing to low-quality care, persistent health disparities, and high health care costs. To address these care gaps quickly, nephrology would benefit from leveraging implementation science: a multidisciplinary field that seeks to close the gap between evidence and practice by examining the optimal approach to help individuals, groups, organizations, and communities implement evidence-based interventions in real-world settings. This Perspective is designed to provide an overview of the field of implementation science and summarize how to apply implementation science in nephrology to address health disparities. To illustrate how to leverage implementation science for health equity, we also showcase 2 case examples focused on (1) addressing disparities in the use of sodium/glucose cotransporter 2 inhibitors to slow the progression of chronic kidney disease, and (2) increasing equitable access to home dialysis for people with kidney failure.
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