Group Visits Ease Kidney Patient Appointment Overload

Shared medical appointments (SMA) of kidney stone patients allow clinicians to see patients as a group while still providing individualized care, according to a new study.

Researchers at the University of Wisconsin (Madison, USA) conducted a pilot study of SMA with groups of less than ten patients given 60-90 minute appointments. Each appointment included general kidney stone and kidney disease education, individual lab value assessments, and nutritional information based on each patient's needs. The study was launched out of necessity, since the dedicated kidney stone clinic is the only one in the state of Wisconsin, and appointments would often be booked out 180 days in advance. As a result, many patients who did make their appointments had a poor record of compliance with nutritional advice and medications.

Initial findings of the study showed that appointment wait times were reduced to less than 90 days, and the amount of patients receiving nutrition advice increased from 40% to 70%. Patient knowledge of nutrition concepts and risk factors, compared with patients seen individually, was slightly higher. The number of patients seen per month increased 50%, and the time spent with patients in their initial metabolic evaluation increased from 45 minutes to 75 minutes. The study was presented at the spring meeting of the National Kidney Foundation (NKF; New York, NY, USA), held during April 2013 in Orlando (FL, USA).

“Previous studies have shown that the further removed a patient is from his or her kidney stone event, the less likely he is to do something about it, and the more likely he is to experience recurring kidney stones,” said lead author and study presenter assistant professor of medicine Allan Jhagroo, MD. “With new healthcare laws coming into effect, physicians and insurers are looking at ways to increase access and education while simultaneously improving productivity. Our medical group is not much different than other practices that deal with kidney stone patients, so these results are generalizable.”

“As the incidence of chronic kidney disease increases, there will be greater demand for access to nephrologists and other medical specialists,” commented Kerry Willis, MD, senior vice president for scientific activities at the NKF. “This pilot project shows there are ways to streamline specialized care while improving access and education. The findings show a clear benefit to kidney stone patients, and the program could serve as a model for managing other types of kidney patients as well.”

Related Links:
University of Wisconsin
National Kidney Foundation