UK survey of patient and caregiver perspectives on the impact of chronic kidney disease-associated anaemia.

OBJECTIVE: Chronic kidney disease (CKD)-associated anaemia has substantial biopsychosocial impacts. This study explores the impact of CKD-associated anaemia and treatment preferences from the patient perspective. DESIGN: Cross-sectional survey. SETTING: Anonymised online survey implemented by Ipsos UK on behalf of the National Kidney Federation and GSK from October 2022 to January 2023. PARTICIPANTS: Data were collected from UK adults living with CKD (self-reported). PRIMARY AND SECONDARY OUTCOME MEASURES: Outcome measures were exploratory and not predefined. The cross-sectional survey was designed to explore the biopsychosocial impact of living with anaemia on individuals with CKD; their unmet needs; the treatment strategies typically implemented and the associated barriers/facilitators to adherence; the healthcare professional-patient relationship with regard to anaemia diagnosis and management. RESULTS: Of 101 participants, 90 (89%) were patients with CKD and 11 (11%) were informal carers. 96 (95%) participants reported symptom(s) relevant to their experience of CKD. 88 (87%) participants reported symptom(s) associated with anaemia and 61 (64%) expressed an impact on daily life including 18 (19%) unable to perform daily activities, 13 (14%) unable to go to work and 9 (9%) reporting poor social life/interactions. 85 (84%) participants reported they have received treatment for anaemia: intravenous iron (n=55, 54%), iron tablets (n=29, 29%), erythropoietin-stimulating agents (ESAs) via an autoinjector (n=28, 28%), ESA injections via a syringe (n=24, 24%), ESA injections via a dialysis machine (n=17, 17%), folic acid (n=22, 22%) and blood transfusion (n=17, 17%). Six of seven (86%) participants who received their ESA from a healthcare professional at home preferred injections whereas 13/27 (48%) participants who injected themselves at home preferred oral tablets. CONCLUSIONS: There is not a 'one-size-fits-all' approach to the management of CKD-associated anaemia. A personalised approach incorporating the treatment preferences of the individual should be explored when discussing treatment options.

Survey of adherence to sepsis care bundles in six European countries shows low adherence and possible patient risk.

Sepsis is a life-threatening condition which globally claims more lives than cancer. A set of evidence-based clinical practices (sepsis bundles) have been developed to guide early diagnosis and rapid intervention, which are vital to patient survival; however, their use is not widely adopted. A cross-sectional survey was administered in June-July 2022 to understand healthcare practitioner (HCP) knowledge of and adherence to sepsis bundles and identify key barriers to adherence in the UK, France, Spain, Sweden, Denmark and Norway; a total of n=368 HCPs ultimately participated. The results showed that among HCPs, overall awareness of sepsis and the importance of early diagnosis and treatment is high. However, there are indications that adherence to sepsis bundles is well below the standard of care: when asked which steps providers carry out to treat sepsis, only 44% report carrying out all steps in the bundle; and 66% of providers agreed that delays in sepsis diagnosis occur sometimes where they work. This survey also highlighted the possible barriers which are impeding the implementation of optimal sepsis care: particularly high patient caseload and staff shortages. This research highlights important gaps and obstacles in reaching optimal care of sepsis in the surveyed countries. There is a need for healthcare leaders and policy-makers alike to advocate for increased funding for more staff and training to address existing knowledge gaps and improve patient outcomes.