Table 3 Referral practices by non-dietetic health professionals to dietetic services for patients with CKD Stage 3
Question | n (%) | Question | n (%) |
|---|---|---|---|
How often do you refer patients to a renal dietitian in CKD Stage 3 (n = 111) | Reasons for referring patients to a dietitian (n = 104) | ||
Never | 12 (11) | Patients not adhering to advice | 26 (25) |
0–25% of the time | 46 (41) | Patient request | 60 (58) |
26–50% of the time | 21 (19) | Reduce risk of CKD progression | 66 (63) |
51–75% of the time | 9 (8) | Treat malnutrition | 45 (43) |
76–99% of the time | 2 (2) | Oral nutrition support | 51 (49) |
I refer all patients | 21 (19) | Manage fluid overload | 36 (35) |
How often do patients initiate a referral to a renal dietitian? (n = 144) | Electrolyte/weight management education | 11 (11) | |
Never | 20 (14) | Factors perceived to enhance referrals to renal dietitians (n = 110) | |
Sometimes | 93 (64) | Dedicated dietitian | 74 (67) |
Half the time | 21 (15) | Evidence of positive clinical outcomes from DI | 62 (58) |
Most of the time | 9 (6) | Dietitian's skills and experience | 56 (51) |
Always | 1 (1) | Hearing positive feedback from patients | 55 (50) |
What is your preference for who provides dietary advice? (n = 111) | Patient interest | 64 (58) | |
Nephrologist | 4 (4) | Shorter waiting times to see dietitian | 51 (46) |
Renal Dietitian | 98 (88) | Suggestions for improvements to provision of renal dietetic advice (n = 109) | |
Renal Nurse | 0 | Additional training (renal dietary information, counselling skills) | 50 (46) |
Any renal team member | 9 (8) | Better written resources | 70 (64) |
Reasons for not referring patients (n = 107) | All patients to be referred to dietitian once diagnosed with CKD | 61 (56) | |
I can give advice | 13 (12) | Better service provision (frequent appointments, more dietitians) | 60 (55) |
Patient declined referral | 66 (62) | Would you refer patients to a renal dietitian from CKD Stage 3 if the service was available? (n = 111) | |
Visit burden for patients | 35 (33) | Yes | 93 (84) |
Do not think patients will adhere to advice | 9 (8) | No | 3 (3) |
Significant waiting times to see dietitian | 36 (34) | Unsure | 15 (14) |
Poor service provision | 9 (8) | ||
Not enough evidence that diet works in CKD | 12 (11) | ||
Other | 12 (11) | ||