Cape York Kidney Care: service description and baseline characteristics of a client-centred multidisciplinary specialist kidney health service in remote Australia

• Published in: BMC Health Services Research
• Main Authors: Andrea Miller, Leanne Brown, Clara Tamu, Alice Cairns
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2023
• Subjects: Chronic disease; Chronic kidney disease; Primary care; First Nations; Indigenous; Multidiscplinary; Public aspects of medicine; RA1-1270; Cape York
• Online Access: https://doi.org/10.1186/s12913-023-09887-6; https://doaj.org/article/c3f45c6654484d72908af44696bbc821

Abstract Background Chronic Kidney disease (CKD) is over-represented amongst First Nation people with more than triple the rate of CKD in those aged 15 years and over. The impact of colonisation, including harmful experiences of health practices and research, has contributed to these health inequities. Cape York Kidney Care (CYKC) has been created as an unique service which provides specialist care that aims to centre the client within a multidisciplinary team that is integrated within the primary care setting of the remote health clinics in six communities in western Cape York, Australia. This research aims to describe the Cape York Kidney Care service delivery model, and baseline service data, including aggregated client health measures. Methods The model of care is described in detail. Review of the first 12 months of service provision has been undertaken with client demographic and clinical profile baseline data collected including kidney health measures. Participants are adults (> 18 years if age) with CKD grades 1–5. This data has been de-identified and aggregated. Results CYKC reviewed 204 individuals, with 182 not previously been reviewed by specialist kidney health services. Three quarters of clients identified as Aboriginal. The average age was 55 with a high level of comorbidity, with majority having a history of hypertension and Type 2 diabetes (average Hba1c 8.2%). Just under one third had cardiovascular disease. A large proportion of people had either Grade 2 CKD (32%) or Grade 3 CKD (~ 30%), and over half had severely increased albuminuria (A3), with Type 2 diabetes being the predominant presumed cause of CKD. Most clients did not meet evidence-based targets for diabetes, blood pressure or lipids and half were self-reported smokers. The proportion of clients reviewed represents 6.2% of the adult population in the participating First Nation communities. Conclusion The CYKC model was able to target those clients at high risk of progression and increase the number of people with chronic kidney ...