Reasons for Underreporting of Uremic Pruritus in People With Chronic Kidney Disease: A Qualitative Study.

Aresi, Giovanni, Rayner, Hugh C, Hassan, Lamiece, Burton, James O, Mitra, Sandip, Sanders, Caroline and van der Veer, Sabine N (2019) Reasons for Underreporting of Uremic Pruritus in People With Chronic Kidney Disease: A Qualitative Study. Journal of pain and symptom management, 58 (4). 578-586.e2. ISSN 1873-6513. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs.

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Official URL: https://www.jpsmjournal.com/article/S0885-3924(19)...

Abstract

CONTEXT

Uremic pruritus, or itch, is common in people with chronic kidney disease (CKD) and has a negative impact on their lives and well-being. However, for reasons currently unknown, itch often remains unreported and therefore untreated.

OBJECTIVES

To explore reasons for underreporting of itch to provide pointers for improving itch reporting and management in people with CKD.

METHODS

We interviewed adult patients with CKD who self-reported experiencing itching in the last three years (n = 25), nephrologists (n = 10), and nurses (n = 12) from three kidney services in the U.K. Topic guides were informed by previous studies and a theoretical model of self-regulation. We conducted a thematic analysis of verbatim transcripts using framework analysis.

RESULTS

We identified the following three main themes reflecting factors that may influence whether itch is reported: knowledge on causes and treatment of itch (lack of awareness of the relationship between itch and CKD, and lack of knowledge of treatment options); attitudes toward importance of itch as a health issue (patients' and clinicians' attitudes); and prompts for itch assessment during consultations (routine practice, itch as a marker, and itch severity).

CONCLUSION

Underreporting of itch is related to patients being unaware of its causes, accepting it as something to live with, prioritizing other health issues, and the length and timing of consultations. Health care professionals' assessment and management of itch vary widely and are not necessarily evidence-based. Better patient information, development of clinical practice guidelines, and incorporation of routine symptom assessments into care may improve itch reporting and management in people with CKD.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs.
Subjects: WJ Urogenital system. Urology
WR Skin. Dermatology
Divisions: Emergency Services > Renal
Related URLs:
Depositing User: Mrs Noomi Tyholdt-Pidgley
Date Deposited: 29 Jan 2021 10:06
Last Modified: 29 Jan 2021 10:06
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3904

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