Curtis Warfield: Proactive Education, Management Will Improve Lifestyle Intervention Adherence for Patients With CKD

A more proactive rather than reactive approach is needed from nephrologists in educating patients with chronic kidney disease (CKD) on lifestyle interventions that are specific to their respective care needs, said Curtis Warfield, MS, senior quality analyst, Indiana State Department of Health, and regional leader of National Kidney Foundation (NKF)'s Kidney Advocacy Committee.

Diagnosed in 2012 with stage 3 CKD, Warfield is a transplant recipient who serves on several committees, including NKF's Patient Diversity Workgroup and the NKF/American Society of Nephrology (ASN) Task Force.

Warfield spoke during a session at the ASN Kidney Week 2022 meeting, titled, “Barriers and Facilitators to Adopting Lifestyle Interventions: A Patient's Perspective.”

Transcript

How would you describe the current process of educating, applying, and managing lifestyle intervention strategies for patients with CKD?

Well, I see the way things that are being taught to patients or educating patients as being in a more reactive mode. It's a thing where the patient will go into maybe the next stage or is diagnosed and then education comes up. It's, like I said, reactionary, instead of proaction.

So, we need to change that to where education is done with the patient as the patient is going through different stages, instead of here's what happened and here's what you need to do now. That's the way I see things.

From the patient perspective, what barriers impede adherence and integration of common lifestyle interventions suggested for CKD management and how may these challenges impact equitable care outcomes?

I see these inequities as being, one, as we talked about, education. People need to know what's going on. They need to understand exactly what kidney disease is about, what has affected them, how that has affected them. And then what can they do about it, be it dietary, be it exercise, just learning more. When they understand, their family understands because their family is going to be their biggest support.

So, we need to really stress or I really stress that education piece along with getting to know your doctor and trying to build that relationship so that you can get a better understanding between the 2 of you of what's going on.

What are some factors that nephrologists and other managing clinicians should consider in choosing lifestyle interventions that are specific to each individual patient’s needs?

I see and I feel that nephrologists should learn about the patient, learn about the patient's lifestyle, learn about their background, their culture. What do they eat? Where do they live? Are they in a type of food desert? Are they low income? Are they high income?

Their educational background—things that make that patient tick. And if you learn more about the person then you can kind of drive your care plans towards them and make them feel a little better about what they're dealing with and also see what's going on and treat them better.