Improving the management of chronic kidney disease in remote Indigenous communities is the goal of Bhavini Patel, director of pharmacy at the Royal Darwin Hospital, who has just received a two-year Fellowship from the National Institute of Clinical Studies.
Co-sponsor of the Fellowship is the Health and Medical Research Foundation of the Hospitals Contribution Fund (HCF).
Ms Patel will use the two year NICS-HCF Foundation Fellowship to address a serious evidence-practice gap in the treatment of chronic kidney disease in Indigenous Australians and expects the quality improvement interventions she employs in this project to assist the management of other chronic conditions.
The incidence of chronic kidney disease around Australia is on the increase, most significantly amongst Indigenous Australians. In remote areas, the rates are around 35 times higher than amongst non-Indigenous Australians. When treatment is required, these people have to travel long distances away from their family, social and cultural supports to access services. This has a significant psychosocial and financial cost to the community.
?Kidney function involves filtering waste products and removing extra water from the body, and maintaining the blood?s chemical balance. Dialysis or a kidney transplant becomes necessary when chronic kidney disease reduces the function of the kidneys to less than 10 to 15 per cent.? explains Ms Patel.
There is strong evidence that managing high blood pressure can delay the need for dialysis and that an arteriovenous fistula is the most effective means of creating a permanent access to veins for people needing haemodialysis.
Better systems of care are required to target gaps between best evidence and current health care delivery.
According to Ms Patel, increasing use of an arteriovenous (AV) fistula to start haemodialysis could have a dramatic impact on Indigenous health because it is known to reduce hospitalizations, infection risk and other complications.
?The evidence strongly supports using an AV fistula to commence haemodialysis but currently they are used in less than 50 per cent of people starting haemodialysis.
Figures are lower for certain groups of Indigenous Australians. This is why I?ll make this intervention the focus of my Fellowship,? she said.
?As Australia?s national agency for closing gaps in health care, NICS is delighted to award this Fellowship to Ms Patel. We are very grateful to the HCF Health and Medical Research Foundation for their generous support of this important work,? said NICS Chief Executive Officer, Dr Heather Buchan.
Ms Patel will join five other health professionals from Victoria, Tasmania and Western Australia in the NICS Fellowship program for 2007.