Minority dialysis patients report unmet supportive care needs

Asian American or Native Hawaiian or other Pacific Islander patients and Black patients receiving maintenance hemodialysis are more likely to report a range of unmet supportive care needs than whites, according to a research letter published online July 11 in JAMA Internal Medicine.

Catherine R. Butler, M.D., from the University of Washington in Seattle, and colleagues surveyed 997 adults who were receiving maintenance dialysis at 31 facilities regarding palliative and end-of-life care. The association between racial and ethnic group and unmet care need was examined. The analytic cohort included 113 Asian American or Native Hawaiian or other Pacific Islander (12 percent), 270 Black (29 percent), and 565 White participants (60 percent).

The researchers found that compared with whites, Asian American or Native Hawaiian or other Pacific Islander participants and Black participants were significantly more likely to report wanting to learn about treating pain (55 and 53 percent, respectively, versus 39 percent) and treating symptoms of kidney disease (70 and 68 percent, respectively, versus 52 percent). Increases were also seen for these groups in the likelihood of reporting a desire to speak to someone about the meaning of life (23 and 17 percent, respectively, versus 8 percent), finding peace of mind (31 and 24 percent, respectively, versus 17 percent), wanting help in sharing their thoughts and feelings with those closest to them (41 and 32 percent, respectively, versus 22 percent), and finding spiritual resources (27 and 19 percent, respectively, versus 11 percent).

“The study results suggest a need for practice interventions and policy initiatives to promote equitable access to health services, including palliative and supportive care,” the authors write.

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