Table 1.

Priorities of the Coalition for Supportive Care of Kidney Patients

PriorityGoal
1. Enhance efforts to help patients, their families, and their providers to better understand the expected course of their diseaseDevelop robust prognostic models to provide patients with advanced CKD with realistic expectations in terms of life expectancy, illness trajectory, and future treatment decisions
Promote research to augment information on patient-centered outcomes associated with different treatment options that can be generalized to real-world clinical settings
Encourage the development and implementation of point-of-care decision support tools tailored to patients with CKD
2. Promote shared decision making for patients with advanced CKDEnhance efforts to elicit patient goals, values, and preferences
Provide communication skills training for clinicians caring for patients with CKD
Support reimbursement for clinician time spent in shared decision-making with patients and their families
Promote advance care planning for patients with kidney disease, beginning early in the disease course and continuing as the illness progresses
3. Tailor treatment strategies to what matters most to individual patientsAlign treatment plans and quality metrics to optimize patient-important goals and preferences to maximize patient quality of life
Encourage regulatory and practice changes to allow for greater flexibility in the timing and prescription of dialysis and the development of strong positive treatment alternatives to dialysis
Promote regulatory changes for greater integration of hospice and palliative care into other aspects of the care of patients with advanced kidney disease as needed to support patient goals and preferences
Increase palliative care training, both in nephrology fellowship programs and continuing medical education