Project Details

Description

Depression affects 23-39% of chronic kidney disease (CKD) patients, impacting significantly upon quality of life. There is established evidence demonstrating the association between depression and mortality in CKD. Recognising and treating depression in CKD should be a clinical priority, yet evidence for effective treatments in CKD is lacking. Currently little is known how best to treat depression in CKD patients. There are national guidelines on the clinical management of people with long-term conditions (LTCs) with depression, yet we do not know how these guidelines are implemented within the renal context, and if they are helpful in supporting the identification and treatment of depression.

The aim of this project is to understand current national practice patterns for the identification and management of depression in CKD, in order to recommend clinical pathways for the identification and management of depression in CKD, which can be tested in future studies.

The research will be mixed-methods over 30 months. First, we will systematically review existing research that has examined how to treat people with LTCs (including CKD) and depression. This will lead to the development of a questionnaire to send to all UK renal services, asking how they identify and treat CKD patients with depression. The questionnaire will be co-produced with an ‘expert stakeholder group’ including patients, carers and health care professionals (HCPs), including GPs. From this questionnaire we will be able to identify variation in practice patterns. With our expert stakeholder group, we will select six renal services across the UK, as ‘case studies’, in order to explore in detail how CKD
patients with depression are treated and supported. We will review these services local policies for psychosocial support, interview staff and patients and other HCPs. We will also ask CKD patients with different ethnic backgrounds to complete a short survey, to gain their experiences of mental health support. This case study approach will provide a thorough description of the current treatment pathways for depression across UK renal services.

The findings will be discussed with the expert panel and other relevant stakeholders to identify examples of best practice and make recommendations for national clinical pathways of care in CKD. We will disseminate our findings nationally with the aim of facilitating future research designed to test aspects of the pathway, including treatments trials. This proposal has been developed in collaboration with a patient and public involvement group and Nick Palmer (kidney patient and co-applicant).

Layman's description

Currently little is known about how best to treat depression in Chronic Kidney Disease (CKD) patients. There are national guidelines to guide the clinical management of people with long-term conditions with depression. However, we do not know how these guidelines are used, or whether they are helpful supporting the management of depression in people with CKD.
We aim to better understand how adults with CKD and depression are identified and treated, and to use this information to design effective management pathways. The research will be conducted in stages over 30 months. First, we will review existing research that has examined how best to treat people with LTCs and depression. From this review, we will develop a questionnaire to send to all UK renal services, asking them how they identify and treat adults with CKD and depression. This questionnaire will be developed in collaboration with an ‘expert stakeholder group’ including kidney patients, carers and health care professionals. From this survey we expect to find variation in approaches to supporting people with CKD and depression (called ‘practice patterns’) across renal services. In collaboration with our expert stakeholder group, we will select six renal services with different practice patterns, from different locations in the UK, as ‘case studies’ to explore in detail how people with CKD and depression are treated and supported. We will visit these services, review local policies, interview staff and patients and other relevant health professionals. We will also ask people with CKD from different ethnic backgrounds to complete a short survey, to gain their experiences of mental health support.
This case study approach should provide a rich description of the treatment and care pathways of adults with CKD and depression across the UK. Finally, the findings will be discussed with the expert panel and other relevant stakeholders to identify examples of best practice and make recommendations for an effective pathway of care for people with CKD and depression.
Short titleMoodMaps
StatusFinished
Effective start/end date1/07/2030/09/23

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