IMPLEMENTATION AND EVALUATION OF A COMPREHENSIVE RENAL TRANSPLANTATION PREHABILITATION ALLIED HEALTH MODEL OF CARE
Miss Suzannah Jackson1, Mrs ANDREA ELLIOTT2, Dr CHRISTOPHER SIA3, Dr CASSIE MCDONALD2
1Nutrition Department, Alfred Health, Melbourne, Australia, 2Department of Allied Health, Alfred Health, Melbourne, Australia, 3Department of Renal Medicine, Alfred Health, Melbourne , Australia, 4Department of Critical Care, University of Melbourne, Melbourne, Australia
Aim: Implement a pilot allied health prehabilitation allied health service for adults preparing for kidney transplantation and evaluate feasibility and acceptability.
Background: Comprehensive multidisciplinary assessment and treatment is recognised to optimise outcomes in renal transplant recipients. Pilot prehabilitation studies have shown feasibility, positive physical outcomes and satisfaction.
Methods: A pilot allied health model of care was implemented at a metropolitan health service in Melbourne, Australia from December 2023 to patients preparing for transplantation. Assessment and targeted interventions were provided by a Physiotherapist, Dietitian, Social Worker and Neuropsychologist. Data on number of referred patients assessed and appointment attendance were collected. Patient outcomes were measured at baseline and 3 months for frailty using the Fried Frailty Score, malnutrition using the PG-SGA and quality of life with the KD-QOL. Acceptability surveys informed by the Theoretical Framework of Acceptability were conducted. Data were analysed using descriptive statistics.
Results: Of 40 patients referred, 84% were assessed or assessment scheduled, with high appointment attendance (face-to-face 98%; telehealth 92%). Allied Health assessments detected frailty (frailty 18%, pre-frailty 43%), malnutrition (moderate 53%, severe 3%) poor quality of life (KD-QoL<50% 66%) with targeted interventions provided by Physiotherapy (50%) Dietitian (92%), Social Work (27%) and Neuropsychology (33%).
In small patient numbers (n=8), improvements were seen at 3 months, with 38% having better frailty scores, 38% no longer malnourished and no deterioration in KD-QOL scores. Of 19 patients who completed the survey, all rated the pilot as acceptable (Acceptable 74%, Completely Acceptable 26%).
Conclusion: Evaluation of the pilot AH model of care indicates that it is feasible. Further evaluation of objective measures and acceptability and feasibility of the model is underway to guide future service development.
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Biography:
Suzy completed her Dietetics training and commenced her career in the NHS (UK) working in a large Tertiary Metropolitan Health Service. Since relocating to Melbourne, she has worked as an accredited practicing dietitian within the Renal Unit at Alfred Health providing clinical nutrition services across the Renal Care continuum. She has previously acted as Allied Health Representative on the Victorian Renal Clinical Network Governance committee and has held Clinical Operations roles and progressed a range of Quality Improvement initiatives, including undertaking a Project Lead role in development of the Nutrition and Quality Standards for adults in Victorian public hospitals and residential aged care services. Suzy is passionate about delivering high quality and patient centred care to patients with renal disease.