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Research project to find gold standard mental health support for kidney patients

13 May 2021

One in three kidney patients are thought to suffer with depression and anxiety due to the struggle of complex health needs.

Now, a team of researchers funded by Kidney Research UK are looking into the mental health support available at more than 70 renal services across the country to gather evidence on how to best to support the kidney community.

Dr Joe Chilcott

Psychologist Dr Joe Chilcot and a team at King’s College London and the University of Hertfordshire are investigating the most effective mental health assessment and treatment pathways currently available and how these vary across the UK.

They will then write evidence-based guidelines to support improved mental health services at renal centres in England, Scotland, Wales and Northern Ireland.

Challenges of living with kidney disease

Dr Chilcot said: “Our work will look at treatment options for kidney patients, such as talking therapies including cognitive behaviour therapy, and medications. We will interview staff and patients and also look at all the published scientific evidence.

“The majority of renal services have teams that deal with the psychological side of kidney disease, who do an incredible job. However, the size and provision of these teams varies significantly.

“Often psychosocial support, whilst essential, is not well resourced to meet the challenges many people living with kidney disease face. We aim to understand how care is currently provided and determine what is working most successfully.

“Once we have gathered all the evidence, we will draw up guidelines to better detect and manage depression and anxiety among kidney patients.”

There are currently no specific guidelines on how to support the mental wellbeing of kidney patients – a huge gap when we know how much they are affected by living with a long-term condition.

One in three could be suffering

Dr Chilcot and his team began the research project in October 2020 by looking at the published scientific literature into the mental health of kidney patients and what models of care have been used in people living with a long-term condition more broadly.

They have found that there is moderate evidence for how to best support the mental health needs of people with kidney disease. Next steps will be surveying staff and patients. It is hoped the project will be complete by 2023.

The prevalence of depression in kidney patients is thought to be much higher than in the general population and could be as high as one in three suffering.

Dr Chilcot was inspired to begin the research after discovering plenty of evidence on the mental health impact of long-term illnesses like heart problems and diabetes, but comparably very little for chronic kidney disease, particularly in terms of detection and treatment.

Physical and social challenges

“There are many physical health and social challenges people face when they live with kidney disease, including dialysis, symptom burden, impact on employment, fears around a transplant match and fears also about transplant failure. So it is no surprise to find that people’s mental health is impacted.

“There is a huge appetite for more research in this area at the moment. We are at a critical point where there is a lot of momentum in trying to better understand and support people’s mental health.

"The importance of mental health has been recognised for some time, but it is fair to say that COVID-19 has certainly focused this attention further. We want our research to ultimately help improve all round patient care.”

The findings will be discussed with an expert panel so that they can develop best practices and make recommendations for a new pathway of care for people with chronic kidney disease and depression.

The research is funded thanks to a project grant of £220,000 from Kidney Research UK.

“We need to better understand what seems to work on the ground in order to think about how to best help kidney patients and put our findings into clinical practice.

“We also hope that research like this encourages conversations around mental health and how it is good to talk. The ultimate goal is to improve people’s quality of life.”

Important step to help wellbeing of kidney patients

Dr Aisling McMahon, executive director of research, innovation and policy at Kidney Research UK, said: “We made a commitment with the Centre for Mental Health to work together to highlight this area of significant unmet need in the treatment of kidney patients.

“Joe’s work is a really important first step as it will provide a much-needed comprehensive analysis of current mental health services for kidney patients in the UK and raise awareness of the problems people face.

"We anticipate this evidence will be used to transform mental health treatments for kidney patients so they can receive correctly tailored mental health support.”

Dr Joe Chilcot is a Reader in Health Psychology at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London.

Some personal stories on the impact of kidney disease on mental health and wellbeing:

Holly Loughton;  Sarah Green;  Sarah Robinson;  Paul Matthews

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