NQF Publishes Guide on Shared Decision-Making in Kidney Disease

The guide will help providers integrate shared decision-making into care plans for chronic kidney disease.

By Sara Heath

October 10, 2019 - Shared decision-making, patient education, and patient goal setting are all crucial elements to effective chronic kidney disease treatment, the National Quality Forum (NQF) asserts in its latest guidance for improving chronic kidney disease care.

The guidance, which serves as a playbook for shared decision-making for patients with chronic kidney disease (CKD), specifically aims to drive more patient-centered and high-quality healthcare.

“Chronic kidney disease and end-stage renal disease are complex in nature and present unique challenges for those faced with determining the best route of care, often under time-sensitive or other extenuating circumstances,” said Kathleen Giblin, Senior Vice President of Quality Innovation, National Quality Forum. “Early inclusion of the patient voice is imperative in improving the quality and type of care that reshapes the lives of those affected.”

Currently, 30 million individuals, or 15 percent of all US adults, have CKD. Of those individuals, 726,000 have end-stage renal disease, which is the most severe form of CKD. As patients progress toward end-stage renal disease, their treatment options shrink while the burden on their personal lifestyles and quality of life grows.

As a result, some medical professionals are calling for better integration of patient preferences and shared decision-making as a part of chronic care management.

However, fewer than half of all patients with CKD report that their providers are asking their opinions of or preferences for certain treatment options, suggesting a knowledge gap between patients and providers that is hampering patient-centered care.

The NQF playbook, Supporting Shared Decision Making for Individuals with Chronic Kidney Disease and End-Stage Renal Disease, aims to address that gap in patient health literacy and decision-making.

“We recognize the importance of shared decision making in renal care and are proud to champion the transformative role it plays in our latest Playbook.” continued Giblin. “To advance patient-centered care, clinicians and the healthcare community-at-large can utilize the resource to take action, reduce knowledge gaps and empower patients in important care decisions.”

The playbook, which NQF developed using input from patient engagement experts and patients themselves, outlines strategies different provider stakeholders can use to drive shared decision-making in chronic kidney disease.

Using patient-centered approaches, medical providers can ensure patients are knowledgeable about their healthcare status and the treatments available to them, working to integrate patients into the healthcare experience and making them partners in care.

Shared decision-making has grown in prominence in recent years, likely sparked by its inclusion in various standards of care established by NQF. Previously, medical providers cited limited time during appointments and a murky idea of what constitutes patient activation in decision-making as barriers keeping some providers from engaging in the practice.

But in 2018, NQF established shared decision-making as one of its key standards of care, an effort the Forum says will ideally lead more providers to tapping into the patient-provider communication strategy.

“Studies over the last several decades show how shared decision-making, and in particular use of high quality decision aids – which are tools to support shared decision-making and identifying risks, benefits, and patient values – can lead to improved patient outcomes in terms of helping patients better understand the information related to their condition,” Kim Ibarra, a managing director at NQF, said in a previous interview.

“Shared decision-making helps patients feel more confident about the decisions that they’re making, feel more satisfied or have better experiences with their care providers and the healthcare system,” she added.

While this proclamation from NQF may not have made a difference in the approaches to shared decision-making that had long seemed cumbersome for providers, it did show the healthcare industry that the strategy was important. It may have pushed more providers to set shared decision-making as a priority during care encounters.

And for its part, NQF has been working to help educate more providers about shared decision-making. This communication has not traditionally been a part of medical education, so through a series of playbooks like the one NQF just published, the Forum has worked to educate providers in shared decision-making.

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