Catherine R Butler, Akanksha Nalatwad, Katharine L Cheung, Mary F Hannan, Melissa D Hladek, Emily A Johnston, Laura Kimberly, Christine K Liu, Devika Nair, Semra Ozdemir, Fahad Saeed, Jennifer S Scherer, Dorry L Segev, Anoop Sheshadri, Karthik K Tennankore, Tiffany R Washington, Dawn Wolfgram, Nidhi Ghildayal, Rasheeda Hall, Mara McAdams-DeMarco
{"title":"Establishing Research Priorities in Geriatric Nephrology: A Delphi Study of Clinicians and Researchers.","authors":"Catherine R Butler, Akanksha Nalatwad, Katharine L Cheung, Mary F Hannan, Melissa D Hladek, Emily A Johnston, Laura Kimberly, Christine K Liu, Devika Nair, Semra Ozdemir, Fahad Saeed, Jennifer S Scherer, Dorry L Segev, Anoop Sheshadri, Karthik K Tennankore, Tiffany R Washington, Dawn Wolfgram, Nidhi Ghildayal, Rasheeda Hall, Mara McAdams-DeMarco","doi":"10.1053/j.ajkd.2024.09.012","DOIUrl":null,"url":null,"abstract":"<p><strong>Rationale & objective: </strong>Despite substantial growth in the population of older adults with kidney disease, there remains a lack of evidence to guide clinical care for this group. The Kidney Disease and Aging Research Collaborative (KDARC) conducted a Delphi study to build consensus on research priorities for clinical geriatric nephrology.</p><p><strong>Study design: </strong>Asynchronous modified Delphi study.</p><p><strong>Setting & participants: </strong>Clinicians and researchers in the US and Canada with clinical experience and/or research expertise in geriatric nephrology.</p><p><strong>Outcome: </strong>Research priorities in geriatric nephrology.</p><p><strong>Analytical approach: </strong>In the first Delphi round, participants submitted free-text descriptions of research priorities considered important for improving the clinical care of older adults with kidney disease. Delphi moderators used inductive content analysis to group concepts into categories. In the second and third rounds, participants iteratively reviewed topics, selected their top 5 priorities, and offered comments used to revise categories.</p><p><strong>Results: </strong>Among 121 who were invited, 57 participants (47%) completed the first Delphi round and 48 (84% of enrolled participants) completed all rounds. After 3 rounds, the 5 priorities with the highest proportion of agreement were: 1) Communication and Decision-Making about Treatment Options for Older Adults with Kidney Failure (69% agreement), 2) Quality of Life, Symptom Management, and Palliative Care (67%), 3) Frailty and Physical Function (54%), 4) Tailoring Therapies for Kidney Disease to Specific Needs of Older Adults (42%), and 5) Caregiver and Social Support (35%). Health equity and person-centricity were identified as cross-cutting features that informed all topics.</p><p><strong>Limitations: </strong>Relatively low response rate and limited participation by private practitioners and older clinicians and researchers.</p><p><strong>Conclusions: </strong>Experts in geriatric nephrology identified clinical research priorities with the greatest potential to improve care for older adults with kidney disease. These findings provide a roadmap for the geriatric nephrology community to harmonize and maximize the impact of research efforts.</p>","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":""},"PeriodicalIF":9.4000,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Kidney Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1053/j.ajkd.2024.09.012","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Rationale & objective: Despite substantial growth in the population of older adults with kidney disease, there remains a lack of evidence to guide clinical care for this group. The Kidney Disease and Aging Research Collaborative (KDARC) conducted a Delphi study to build consensus on research priorities for clinical geriatric nephrology.
Study design: Asynchronous modified Delphi study.
Setting & participants: Clinicians and researchers in the US and Canada with clinical experience and/or research expertise in geriatric nephrology.
Outcome: Research priorities in geriatric nephrology.
Analytical approach: In the first Delphi round, participants submitted free-text descriptions of research priorities considered important for improving the clinical care of older adults with kidney disease. Delphi moderators used inductive content analysis to group concepts into categories. In the second and third rounds, participants iteratively reviewed topics, selected their top 5 priorities, and offered comments used to revise categories.
Results: Among 121 who were invited, 57 participants (47%) completed the first Delphi round and 48 (84% of enrolled participants) completed all rounds. After 3 rounds, the 5 priorities with the highest proportion of agreement were: 1) Communication and Decision-Making about Treatment Options for Older Adults with Kidney Failure (69% agreement), 2) Quality of Life, Symptom Management, and Palliative Care (67%), 3) Frailty and Physical Function (54%), 4) Tailoring Therapies for Kidney Disease to Specific Needs of Older Adults (42%), and 5) Caregiver and Social Support (35%). Health equity and person-centricity were identified as cross-cutting features that informed all topics.
Limitations: Relatively low response rate and limited participation by private practitioners and older clinicians and researchers.
Conclusions: Experts in geriatric nephrology identified clinical research priorities with the greatest potential to improve care for older adults with kidney disease. These findings provide a roadmap for the geriatric nephrology community to harmonize and maximize the impact of research efforts.
期刊介绍：
The American Journal of Kidney Diseases (AJKD), the National Kidney Foundation's official journal, is globally recognized for its leadership in clinical nephrology content. Monthly, AJKD publishes original investigations on kidney diseases, hypertension, dialysis therapies, and kidney transplantation. Rigorous peer-review, statistical scrutiny, and a structured format characterize the publication process. Each issue includes case reports unveiling new diseases and potential therapeutic strategies.
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