Many people with kidney disease are also at risk of heart disease. However, some of the tests used to diagnose and treat heart disease (e.g., angiograms, angioplasty, or surgery) pose unique health risks to people with compromised kidneys. It’s therefore important that kidney patients understand the risks versus benefits of doing these procedures and use that information to make informed decisions regarding their health care.
The APPROACH research project is working with patients with kidney disease and care providers to create tools that can help doctors provide personalized information on the benefits versus risks of having a heart procedure, as well as help patients better communicate their own values and preferences to their doctor. The research team conducted a series of studies and interviews with patients to understand their preferences and values and how they vary according to risk, to inform decision-making for testing or treating heart disease. The perspectives of health providers were also explored. Using these data, the research team created a decision aid, called My Heart Care and CKD, that supports shared decision-making between kidney patients and their care providers.
Having completed the co-development of the decision aid with patients and health care providers to support decision-making and improve communication between patients and doctors, the APPROACH team is now working to implement and evaluate its use in clinical practice in a pilot trial in sites across Canada. The team, which includes patient partners and a Knowledge Keeper, are also working to develop additional supports linked to the tool to meet the needs of underserved populations (e.g., Indigenous communities, women, and certain ethnic groups) at risk of heart and kidney disease.