For patients suffering from end-stage renal disease (ESRD), there are two major treatment options: dialysis and kidney transplant. Of these two options, medical studies have shown that receiving a kidney transplant offers a better chance of survival and quality of life, eliminating the need for hours of dialysis treatment.
Although it is required by law for clinicians or physicians to discuss kidney transplant as a treatment option for their ESRD patients, Emory epidemiologist Rachel Patzer, PhD, MPH, assistant professor of surgery, says that many eligible patients are not being referred for kidney transplantation. Through her research, Patzer found that such disparities were often present in regions outside the Atlanta area.
“There are disparities in who is getting access to that information about transplant, which I think is leading to some of the disparities we see in access to getting on the waiting list and receiving a transplant,” Patzer says.
In order to address these treatment disparities and help patients understand the best treatment option for their individual cases, Patzer and the Emory transplant team created the iCHOOSE Kidney iPad application. The iCHOOSE Kidney app is a shared-decision making tool for providers or clinicians to use with their patients to inform them about potential risks and benefits of each treatment. “The app basically walks you through different risks for treatment options,” Patzer says.
While Patzer says the optimal treatment for kidney disease is transplant, she says this depends on patients’ individualized risk profile, which includes factors such as their age and other possible medical conditions they may have.
Upon a patient’s initial diagnosis of end-stage kidney disease, physicians or clinicians can enter in patient data into the iCHOOSE Kidney app, which in turn calculates the risks of dying on dialysis versus a kidney transplant. The app calculates both relative and absolute risks based on data from a national database of almost 700,000 patients.
The app tries to keep things simple for patients by presenting data in a picture format. Patzer says illustrating information visually is one of the best ways to convey risks to patients. “Showing patients you’re going to live this many years longer or that this is 10 times better is really more powerful than just giving them the average,” Patzer says.
The app is currently being used at the Emory Transplant Center and in the surrounding community. Patzer says that the Emory transplant surgeons and nephrologists use the iCHOOSE Kidney app as part of their communication and education with patients. You can find the iChoose Kidney app by searching your App Store.