PATIENT EXPERIENCE IN RENAL CARE: RESULTS FROM THE KIDNEY PREM SURVEY ACROSS CATALONIA

 

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https://storage.unitedwebnetwork.com/files/1099/c6e6d92eccb6e1d1c8b655749806aa1c.pdf
PATIENT EXPERIENCE IN RENAL CARE: RESULTS FROM THE KIDNEY PREM SURVEY ACROSS CATALONIA

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Meritxell
Ibernon
Meritxell Ibernon mibernonv@csi.cat Complex Hospitalari Hospital Moises Broggi Nephrology Barcelona Spain *
Rosa Ramos roramos@clinic.cat Institute of Nephrology &Urology,Hospital Clínic of Barcelona Nephrology Barcelona Spain -
Montserrat Moharra mmoharra@gencat.cat Agència de Qualitat i Avaluació Sanitàries de Catalunya Generalitat de Catalunya Barcelona Spain -
Laia Sans laia.sans@vallhebron.cat Hospital Vall d'Hebron Nephrology Barcelona Spain -
Joan Manel Díaz jdiaz@fundacio-puigvert.es Fundació Puigvert Nephrology Barcelona Spain -
Xavier Fulladosa xfulladosa@bellvitgehospital.cat Hospital de Bellvitge Nephrology Barcelona Spain -
Isabel Garcia isabel0408@yahoo.es Hospital Ses Espases Nephrology Palma de Mallorca Spain -
Joan Carles Martínez jcmartinez@tauli.cat Hospital Parc Taulí Nephrology Sabadell Spain -
Laureà Pérez lperez@chv.cat Hospital de Vic Nephrology Vic Spain -
Ivan Fraile ivan.fraile@diaverum.com Diaverum Dialysis Center Nephrology Barcelona Spain -
Evelyn Hermida evelyn.hermida@fmc-ag.com Fresenius Medical Care Nephrology Barcelona Spain -
Sara Hurtado sara.hurtado@freseniusmedicalcare.com Fresenius Medical Care Nephrology Barcelona Spain -
Laura Ribera laura.ribera@freseniusmedicalcare.com Fresenius Medical Care Nephrology Barcelona Spain -
Marta Arias marias@clinic.cat Hospital Clinic de Barcelona Nephrology Barcelona Spain -
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Patient-reported experience measures (PREMs) are essential tools for evaluating the quality of care in chronic kidney disease (CKD). The Kidney PREM, originally developed in the United Kingdom, has been culturally adapted into Catalan and Spanish and implemented across multiple nephrology departments in Catalonia to assess patient experience across different treatment modalities and care settings.

A multicenter, cross-sectional study was conducted between September 2023 and May 2024 in 13 nephrology units and dialysis centers across Catalonia. Adult patients with CKD stages IV–V, undergoing hemodialysis, peritoneal dialysis, kidney transplantation, or outpatient nephrology follow-up, completed the Kidney PREM questionnaire anonymously. Sociodemographic data, self-perceived health status (EQ-5D-5L), and use of digital health tools were also collected. 

A total of 575 patients participated (66% male; mean age 67±14 years). Of these, 49% were on hemodialysis, 11% on peritoneal dialysis, 22% were transplant recipients, and 18% attended outpatient nephrology consultations.

Transplant recipients and peritoneal dialysis patients were younger and reported better perceived heath compared with those on hemodialysis or in outpatients care ( mean EQ-5D-5L scores: transplant recipients 67.2 ± 19.6, peritoneal dialysis 66 ± 20, outpatients 64 ± 21, hemodialysis 63 ± 19; p < 0.05).  

More than 65% of participants reported using the regional digital health app “La Meva Salut,” with no significant differences between treatment groups.

Patients treated in dialysis centers were older, had reduced mobility, and reported higher levels of pain compared to all those patients in hospital settings.  Their perceived health status was also significantly poorer than that of hospital-treated patients (EQ-5D-5L: 63 vs 68; p=0.01).

Hospital-based patients reported significantly better experiences compared to those treated in Dialysis centers across multiple dimensions of care: emotional support (P4 & P5: 6.59 vs. 6.24; p<0,01 and 6.51 vs 6.19; p=0,006 respectively), communication (P8: 6.62 vs. 6.31; p=0.001), patient information (P13, 6.62 vs 6.39; 0,01), liquid intake and diet information(P14 & P15: 6.53 vs 6.32; p=0,04 and 6.32 vs 6.03;p=0,03); time for test (P18: 6.43 vs 6.19; p=0,03), shared decision-making (P20, P21 & P22: 6.09 vs. 5.51; p=0.002, 6.26 vs 5.72; p= 0,001 and 6.16 vs 5.57; p=0,001), dignity (P23 & P24: 6.51 vs. 5.99; p<0.01 & 6.76 vs 6.46; p<0,01), schedule time planification (P26: 6.52 vs 6.22; p=0,004), support from nephrology team (P29 & P30: 6.83 vs 6.68; p=0,001 and  5.77 vs 5.22;p=0.01 and overall experience (P39: 6.63 vs. 6.41; p=0,003). However, when comparing only hemodialysis patients treated in hospitals versus those treated in dialysis centers,, these differences disappeared—except for transportation (P33: 4.23 vs. 4.97; p=0.02), where patients in dialysis center reported better outcomes.

The adapted Kidney PREM survey reveals high levels of patient satisfaction across renal care modalities in Catalonia, with transplant recipients reporting the most favorable perceived health and experience. Differences in Kidney PREMs between hospitals and dialysis centers are minimal when controlling for treatment modality, suggesting that organizational and relational factors are key drivers of patient perception. Transportation remains a critical area for improvement, particularly for patients requiring frequent travel for hemodialysis. These findings support the integration of PREMs into routine nephrology practice to guide patient-centered care strategies.

Kewords