EXPLORING SICK DAY MANAGEMENT IN CULTURALLY AND LINGUISTICALLY DIVERSE PATIENTS WITH CHRONIC KIDNEY DISEASE

 

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EXPLORING SICK DAY MANAGEMENT IN CULTURALLY AND LINGUISTICALLY DIVERSE PATIENTS WITH CHRONIC KIDNEY DISEASE

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Jing Xin
Goh
Jing Xin Goh jingxin.goh@sydney.edu.au The University of Sydney School of Pharmacy Sydney Australia *
Kamal Sud Kamal.Sud@health.nsw.gov.au The University of Sydney Sydney Medical School Sydney Australia -
Connie Van connie.van@sydney.edu.au The University of Sydney School of Pharmacy Sydney Australia -
Ronald Castelino ronald.castelino@sydney.edu.au The University of Sydney School of Pharmacy Sydney Australia -
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Sick day medication guidance (SDMG) involves recommendations to withhold certain medications during an acute illness to avoid complications such acute kidney injury (AKI) in patients with chronic kidney disease (CKD). These medications include sulfonylureas, angiotensin-converting enzyme (ACE) inhibitors, diuretics, metformin, angiotensin receptor blockers (ARBs) nonsteroidal anti-inflammatory drugs (NSAIDs) and sodium-glucose cotransporter 2 (SGLT2) inhibitors (SADMANS). SDMG can be difficult to understand, especially for people from culturally and linguistically diverse (CALD) backgrounds due to language and health literacy barriers. No studies have looked at the knowledge and experiences of CALD patients with CKD in managing their medications during sick days. Hence, this study aims to describe the knowledge and experiences of CALD patients with CKD in managing medications during sick days and following SDMG.

A mixed method survey was conducted in patients aged >18 years old, attending Blacktown Hospital Regional Dialysis Centre with CKD stages 2-4, taking >2 SADMANS medications. Descriptive statistics was used to describe quantitative data.  

Overall n=75 participants were surveyed. The median age was 69 years, with English as their first language (n=38, 50.7%). Participants were ethnically: Asian (n=29, 39.7%), Caucasian (n=17, 22.7%), Indigenous Australian (n=12,16.0%) and Middle Eastern (n=9, 12.0%). Only n=12 (16.0%) reported having discussions about medications during sick days with their specialist (n=4, 33.3%), general practitioner (GP) (n=4, 33.3%) or pharmacist (n=4, 33.3%). Of these, n=6 (50.0%) reported having a sick day action plan. Although many participants actively manage their health to avoid getting sick (n=71, 94.7%) and believed they could effectively manage their illness by themselves when unwell (n=57, 76.0%), most did not know what medication(s) to stop when unwell (n=40, 54.8%) and therefore would normally contact their GP when unwell (n=67, 89.3%). 

Patients of CALD background showed willingness to manage their health when acutely unwell but lacked practical knowledge and resources like sick day action plans. Better SDMG provision can enable patients to safely and effectively self-manage their medications during acute illness. 

Kewords