Studies Look at Blacks' Noncompliance With Weekly Dialysis Treatment

[okarol]

Kaiser Health Disparities Report: A Weekly Look At Race, Ethnicity And Health

Studies Look at Blacks' Noncompliance With Weekly Dialysis Treatment;

[Apr 30, 2008]

    * "Dialysis 'No-Shows' on Saturdays: Implications of the Weekly Hemodialysis Schedules on Nonadherence and Outcomes," (.pdf) Journal of the National Medical Association: Black hemodialysis patients with appointments scheduled every Tuesday, Thursday and Saturday were less adherent to their treatment schedules than patients with appointments on Monday, Wednesday and Friday, largely because of high no-show rates for Saturday appointments, according to the study by Chamberlain Obialo of Morehouse University's School of Medicine and colleagues. The study, which examined the effect of weekly dialysis treatment schedules of 114 black adults over age 55 for a 12-month period, found that 61% did not attend their scheduled treatment at least once. Compared with other days of the week, patients were more likely to fail to show up for Saturday treatments. Thirty-one percent of patients missed appointments on Saturdays, compared with no-show rates of 8% to 17% on other days of the week. Researchers concluded that dialysis treatment compliance among blacks "remains a major problem," adding that a larger, more diverse study is needed to either "confirm or refute" the findings (Obialo et al, Journal of the National Medical Association, April 2008).

PDF available at http://www.nmanet.org/images/uploads/Journal/OC412.pdf

[Roadrunner]

Have they questioned why blacks don't show on Saturday?

No transportation on weekends?  Weekend train schedules?  Other reasons.

[stauffenberg]

Why not turn the question around and ask what is wrong with medical science that it imposes a treatment regimen on people which is so onerous and destructive of their lifestyle that a large percentage of them fail to comply with it.  Here as elsewhere, the desire is always to blame the patient when the medical profession fails.

[jbeany]

Did they do a comparison study with other groups?  Why the focus on only blacks?  Seems like wanting to skip Saturdays would be a universal problem!

[kimcanada]

Seems like an odd study, I am with stauffenberg on this one,   they can study anything they want, but why don't they do study something that might make dialysis patients enjoy their lives they they are making longer....... just a thought

[flip]

Based on my experience, absenteeism is higher on Saturday than any other day. I don't see that it has any relation to ethnic breakdown. Saturday is the worst day of the week for dialysis patients because we want to enjoy the weekend with friends and family.

[Treasure]

I am one of those Af-Am dialysis patients that may take an occasional Saturday off (and holidays that my family celebrates) ... and it is totally because I have other plans. I would happily keel over from not going to dialysis than miss a special opportunity to spend time with my adult sons or other family members that I, because of dialysis, infrequently see.
Perhaps some sociologist would attribute my behavior to some racial/cultural factor, but, in my case, I don't think that's the case.

I am a dialysis patient with anarchist leanings, but I always try to make arrangements well prior to special events, but sometimes I cannot be accommodated, and that's that. I'm willing to accept that I may not be able to switch days-- if only the center would accept that I have made the informed choice to not go in, and would just stfu! hehehe

I really would like to see the statistics on this type of non-compliance for other groups.  Does the stereotypical passiveness of females make them more compliant on Saturdays than men?  pfffft!

[stauffenberg]

I completely agree with your remarks.  The tone of the study is that there must be something wrong with Blacks that they are non-compliant with a form of treatment which is so horrendous that it positively cries out for non-compliance.  Perhaps Blacks are less compliant because they are more sensible, or have more joie de vivre, than other patients.

[UNIBALLER]

I don't even know why people bother brining race into any equation at all anymore. The only race that matters is the human race.

[spacezombie]

Here as elsewhere, the desire is always to blame the patient when the medical profession fails.

I actually agree with you here. I don't know if it is a black and white issue so much as the fact that a person's hemodialysis schedule doesn't always fit into their lives. I never skip treatments because PD is easy for me to do and easy to fit into my schedule.

[Marlon]

Blacks have historically been treated badly by the white establishment such as that Tuskegee experiment during WWII where the were Infected with Syphilis by the medical staff in a Government research project. So some of the bad medical treatment may be part of the concept that Government paid for health care may make them sicker.
  Maybe Obama can turn things around.

[Romona]

Why did the study target people over 55? I think this proves nothing. There could be numerous reasons to miss. With the age of study group, I would think illness, hospitalization and transportation could be a barrier. I bet a study of a younger group (reguardless of race) 18-29 year olds would show simillar Saturday no shows.
 

[UNIBALLER]

Personally I think this study was a waste of time and that the researchers time could have been better focused towards something more useful and productive to the more important issues of dialysis and kidney disease.