The following is a summary of “Racial Disparities in Health Beliefs and Advance Care Planning Among Patients Receiving Maintenance Dialysis,” published in the APRIL 2023 issue of Pain Management by Saeed, et al.

For a study, researchers sought to investigate racial disparities in prognostic discussions, beliefs about future health, and completion of advance care planning (ACP) documents among patients receiving maintenance dialysis. In addition, they sought to determine whether Black patients receiving maintenance dialysis differ from White patients in prognostic discussions, beliefs about future health, and completion of ACP-related documents.

They surveyed adult patients receiving maintenance dialysis from seven dialysis units in Cleveland, Ohio, and hospitalized patients at a tertiary care hospital in Cleveland. Of the 450 patients approached, 423 (94%) agreed to participate in the study. For the analysis, they included only Black (n=285) and White (n=114) patients. The survey evaluated patients’ knowledge of their kidney disease, attitudes towards chronic kidney disease (CKD) treatment, preferences for end-of-life (EoL) care, reported occurrence of prognostic discussions, experiences with kidney therapy decision-making, dialysis regret, beliefs about health over the next 12 months, and advance care planning. They used stepwise logistic regression to assess the association between race and the occurrence of prognostic discussions, beliefs about future health, and completion of an ACP-related document while controlling for potential confounders.

The study found no significant difference in the frequency of prognostic discussions between Black (11.9%) and White patients (7%) (P=0.15). However, Black patients had lower odds of believing their health would worsen over the next 12 months (OR 0.22, CI 0.12, 0.44) and reporting completion of any ACP-related document  (OR 0.5, CI 0.32, 0.81) than White patients.

The study concluded that racial disparities existed in beliefs about future health and completion of ACP-related documents among patients receiving maintenance dialysis. The findings suggested the need for systemic efforts to investigate differences in health beliefs and address racial disparities in the completion of ACP-related documents.

Reference: jpsmjournal.com/article/S0885-3924(22)01011-9/fulltext