Cape York Kidney Care: service description and baseline characteristics of a client-centred multidisciplinary specialist kidney health service in remote Australia
Abstract Background Chronic Kidney disease (CKD) is over-represented amongst First Nation people with more than triple the rate of CKD in those aged 15 years and over. The impact of colonisation, including harmful experiences of health practices and research, has contributed to these health inequiti...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-08-01
|
| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-09887-6 |
| _version_ | 1797577199797141504 |
|---|---|
| author | Andrea Miller Leanne Brown Clara Tamu Alice Cairns |
| author_facet | Andrea Miller Leanne Brown Clara Tamu Alice Cairns |
| author_sort | Andrea Miller |
| collection | DOAJ |
| description | Abstract Background Chronic Kidney disease (CKD) is over-represented amongst First Nation people with more than triple the rate of CKD in those aged 15 years and over. The impact of colonisation, including harmful experiences of health practices and research, has contributed to these health inequities. Cape York Kidney Care (CYKC) has been created as an unique service which provides specialist care that aims to centre the client within a multidisciplinary team that is integrated within the primary care setting of the remote health clinics in six communities in western Cape York, Australia. This research aims to describe the Cape York Kidney Care service delivery model, and baseline service data, including aggregated client health measures. Methods The model of care is described in detail. Review of the first 12 months of service provision has been undertaken with client demographic and clinical profile baseline data collected including kidney health measures. Participants are adults (> 18 years if age) with CKD grades 1–5. This data has been de-identified and aggregated. Results CYKC reviewed 204 individuals, with 182 not previously been reviewed by specialist kidney health services. Three quarters of clients identified as Aboriginal. The average age was 55 with a high level of comorbidity, with majority having a history of hypertension and Type 2 diabetes (average Hba1c 8.2%). Just under one third had cardiovascular disease. A large proportion of people had either Grade 2 CKD (32%) or Grade 3 CKD (~ 30%), and over half had severely increased albuminuria (A3), with Type 2 diabetes being the predominant presumed cause of CKD. Most clients did not meet evidence-based targets for diabetes, blood pressure or lipids and half were self-reported smokers. The proportion of clients reviewed represents 6.2% of the adult population in the participating First Nation communities. Conclusion The CYKC model was able to target those clients at high risk of progression and increase the number of people with chronic kidney disease reviewed by specialist kidney services within community. Baseline data demonstrated a high burden of chronic disease that subsequently will increase risk of CKD progression and cardiovascular disease. People were seen to have more severe disease at younger ages, with a substantial number demonstrating risk factors for rapid progression of kidney disease including poorly controlled Type 2 diabetes and severely increased albuminuria. Further evaluation concerning implementation challenges, consumer and community satisfaction, and health outcomes is required. |
| first_indexed | 2024-03-10T22:05:45Z |
| format | Article |
| id | doaj.art-c3f45c6654484d72908af44696bbc821 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-10T22:05:45Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-c3f45c6654484d72908af44696bbc8212023-11-19T12:49:41ZengBMCBMC Health Services Research1472-69632023-08-0123111010.1186/s12913-023-09887-6Cape York Kidney Care: service description and baseline characteristics of a client-centred multidisciplinary specialist kidney health service in remote AustraliaAndrea Miller0Leanne Brown1Clara Tamu2Alice Cairns3Torres and Cape Hospital and Health ServiceTorres and Cape Hospital and Health ServiceTorres and Cape Hospital and Health Service, Ngurapai/Horn Island Primary Health Care Centre, Horn IslandMurtupuni Centre for Rural and Remote Health, & Australian Institute of Tropical Health and Medicine, James Cook UniversityAbstract Background Chronic Kidney disease (CKD) is over-represented amongst First Nation people with more than triple the rate of CKD in those aged 15 years and over. The impact of colonisation, including harmful experiences of health practices and research, has contributed to these health inequities. Cape York Kidney Care (CYKC) has been created as an unique service which provides specialist care that aims to centre the client within a multidisciplinary team that is integrated within the primary care setting of the remote health clinics in six communities in western Cape York, Australia. This research aims to describe the Cape York Kidney Care service delivery model, and baseline service data, including aggregated client health measures. Methods The model of care is described in detail. Review of the first 12 months of service provision has been undertaken with client demographic and clinical profile baseline data collected including kidney health measures. Participants are adults (> 18 years if age) with CKD grades 1–5. This data has been de-identified and aggregated. Results CYKC reviewed 204 individuals, with 182 not previously been reviewed by specialist kidney health services. Three quarters of clients identified as Aboriginal. The average age was 55 with a high level of comorbidity, with majority having a history of hypertension and Type 2 diabetes (average Hba1c 8.2%). Just under one third had cardiovascular disease. A large proportion of people had either Grade 2 CKD (32%) or Grade 3 CKD (~ 30%), and over half had severely increased albuminuria (A3), with Type 2 diabetes being the predominant presumed cause of CKD. Most clients did not meet evidence-based targets for diabetes, blood pressure or lipids and half were self-reported smokers. The proportion of clients reviewed represents 6.2% of the adult population in the participating First Nation communities. Conclusion The CYKC model was able to target those clients at high risk of progression and increase the number of people with chronic kidney disease reviewed by specialist kidney services within community. Baseline data demonstrated a high burden of chronic disease that subsequently will increase risk of CKD progression and cardiovascular disease. People were seen to have more severe disease at younger ages, with a substantial number demonstrating risk factors for rapid progression of kidney disease including poorly controlled Type 2 diabetes and severely increased albuminuria. Further evaluation concerning implementation challenges, consumer and community satisfaction, and health outcomes is required.https://doi.org/10.1186/s12913-023-09887-6Chronic diseaseChronic kidney diseasePrimary careFirst NationsIndigenousMultidiscplinary |
| spellingShingle | Andrea Miller Leanne Brown Clara Tamu Alice Cairns Cape York Kidney Care: service description and baseline characteristics of a client-centred multidisciplinary specialist kidney health service in remote Australia BMC Health Services Research Chronic disease Chronic kidney disease Primary care First Nations Indigenous Multidiscplinary |
| title | Cape York Kidney Care: service description and baseline characteristics of a client-centred multidisciplinary specialist kidney health service in remote Australia |
| title_full | Cape York Kidney Care: service description and baseline characteristics of a client-centred multidisciplinary specialist kidney health service in remote Australia |
| title_fullStr | Cape York Kidney Care: service description and baseline characteristics of a client-centred multidisciplinary specialist kidney health service in remote Australia |
| title_full_unstemmed | Cape York Kidney Care: service description and baseline characteristics of a client-centred multidisciplinary specialist kidney health service in remote Australia |
| title_short | Cape York Kidney Care: service description and baseline characteristics of a client-centred multidisciplinary specialist kidney health service in remote Australia |
| title_sort | cape york kidney care service description and baseline characteristics of a client centred multidisciplinary specialist kidney health service in remote australia |
| topic | Chronic disease Chronic kidney disease Primary care First Nations Indigenous Multidiscplinary |
| url | https://doi.org/10.1186/s12913-023-09887-6 |
| work_keys_str_mv | AT andreamiller capeyorkkidneycareservicedescriptionandbaselinecharacteristicsofaclientcentredmultidisciplinaryspecialistkidneyhealthserviceinremoteaustralia AT leannebrown capeyorkkidneycareservicedescriptionandbaselinecharacteristicsofaclientcentredmultidisciplinaryspecialistkidneyhealthserviceinremoteaustralia AT claratamu capeyorkkidneycareservicedescriptionandbaselinecharacteristicsofaclientcentredmultidisciplinaryspecialistkidneyhealthserviceinremoteaustralia AT alicecairns capeyorkkidneycareservicedescriptionandbaselinecharacteristicsofaclientcentredmultidisciplinaryspecialistkidneyhealthserviceinremoteaustralia |