Pre-dialysis counselling and educational programme helps patients make decisions

According to the National Kidney Foundation, patients often do not want to make a decision on their treatment choice, due to reasons such as social influences, limited health literacy, socio-demographics and the need for autonomy.
According to the National Kidney Foundation, patients often do not want to make a decision on their treatment choice, due to reasons such as social influences, limited health literacy, socio-demographics and the need for autonomy.PHOTO: ST FILE

SINGAPORE - When Mr Thomas Tan was diagnosed with kidney failure last year, he was at a loss as to what his next steps should be.

The 45-year-old, who declined to reveal his job, wanted to research his treatment options and choose one that would not affect his job.

However, the clock was ticking, as his doctor said, and delaying treatment could worsen his condition.

But thanks to the National Kidney Foundation's (NKF) educational counselling programme Know Right, Start Right, Mr Tan was able to make the best decision quickly.

Instead of conventional dialysis at a dialysis centre, he now undergoes peritoneal dialysis (PD), which involves him administering his own treatment at home, allowing him to continue working.

Mr Tan is one of the 79 patients who have benefited from the educational counselling programme since it was introduced last year, NKF said in a statement.

The programme was officially launched on Saturday (May 25) at the foundation's third Kidney Care Conference, held at the Lee Kong Chian School of Medicine in Novena.

The programme, a collaboration between NKF and Khoo Teck Puat Hospital (KTPH), involves monthly pre-dialysis talks at the hospital, home visits and peer support groups. Eight pre-dialysis talks have been organised so far.

Said NKF: "The programme aims to equip patients with adequate knowledge of the disease, treatment process and dialysis management and address psychosocial anxiety as early as possible so that patients do not delay treatment."

According to the foundation, patients often do not want to make a decision on their treatment choice, due to reasons such as social influences, limited health literacy, socio-demographics and the need for autonomy.

NKF board director Arthur Lang said in a speech at the conference that a survey done by the foundation showed that 92 per cent of patients who attended the Know Right, Start Right sessions were able to tell and share the main considerations of kidney failure and treatment options.

Calling the outcome "encouraging", Mr Lang said better health literacy "enables patients to make informed decisions and (ensures) confident self-management of their preferred treatment choice."

 
 

With the help from the programme, Mr Tan was able to see a demonstration of PD, which helped to alleviate his worries.

"Previously I did not have a clear picture of which dialysis treatment option to choose and how it would fit into my full-time work. However, during the pre-dialysis talk, the NKF volunteer shared with me about home-based peritoneal dialysis treatment and how I could do it overnight while I sleep," he said.

"He not only addressed my concerns but also mentally prepared me for the treatment."

NKF is currently planning to  expand  the programme to other hospitals.

Permanent Secretary for Health Chan Heng Kee, the guest-of-honour at the event, warned that the number of kidney failure patients in Singapore is expected to rise due to its ageing population and the increasing prevalence of chronic diseases such as diabetes.

In order to reduce the number of kidney failure cases, the risk of diabetes needs to be lowered, said Mr Chan, as he underscored the "war" that the Government declared on diabetes in 2016.

"Now as a small country, Singapore tries not to declare war, we want peace. And certainly, (as) the Ministry of Health, we are not responsible for war," he said.

"But on diabetes, I think we are not ashamed to declare war on diabetes. In fact, we are determined to win this war."