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Renal Education and Choices @ Home (REACH) Project

We know that patients can find it difficult to talk openly about their kidney disease, and that raising the subject of live donor kidney transplantation (LDKT) can seem like an insurmountable hurdle.  We know too that patients and their loved ones can have misconceptions about LDKT. These realities combine to reduce the likelihood of accessing pre-emptive LDKT as a preferred treatment option for many patients. 

The aim of the REACH project (Renal Education and Choices @ Home), which is based at the Royal Infirmary of Edinburgh, is to improve equity of access to pre-emptive LDKT by providing high quality, accessible information to patients and their loved ones in a relaxed setting, and to encourage open discussion about treatment options. 

Kidney doctors in NHS Lothian and NHS Borders can now refer suitable patients to the REACH service – the first of its kind in Scotland.  A nurse helps the patient to plan an informal information session for their friends and family members and facilitates an open discussion about end-stage renal disease, its treatments and the particular advantages of pre-emptive LDKT.  It is made clear to invitees that the session is not aimed at recruiting or assessing any potential living kidney donor, but simply to improve their understanding of the situation faced by their loved one.

The rationale for the home based approach is based on evidence from the Netherlands. The REACH team visited the Erasmus Medical Centre (Rotterdam) in October 2018 and benefitted enormously from learning how the team there have developed their “Kidney Team at Home” service over the last decade. 

The REACH project went live in November 2018, with its first patient visits, and we look forward to sharing our results with you in the future! For further information contact: orla.hobson@nhslothian.scot.nhs.uk.