Lessons learned from a periodontal intervention to reduce progression of chronic kidney disease among Aboriginal Austral

  • PDF / 768,539 Bytes
  • 5 Pages / 595.276 x 790.866 pts Page_size
  • 76 Downloads / 179 Views

DOWNLOAD

REPORT


BMC Research Notes Open Access

RESEARCH NOTE

Lessons learned from a periodontal intervention to reduce progression of chronic kidney disease among Aboriginal Australians Lisa M. Jamieson1*  , Cherian Sajiv2, Alan Cass3, Louise J. Maple‑Brown3, Michael R. Skilton4, Kostas Kapellas1, Basant Pawar2, Peter Arrow5, Lisa M. Askie6, Wendy Hoy7, David Harris8, Alex Brown9 and Jaquelyne T. Hugh es3,10

Abstract  Objective:  Periodontal disease is associated with chronic kidney disease (CKD), with both conditions being highly prevalent among Australia’s Aboriginal population. This paper reflects on the lessons learned following implementa‑ tion of a periodontal intervention in the Central Australian region of the Northern Territory among Aboriginal adults with CKD. Results:  Between Oct 2016 and May 2019, research staff recruited 102 eligible participants. This was far below the anticipated recruitment rate. The challenges faced, and lessons learned, were conceptualised into five specific domains. These included: (1) insufficient engagement with the Aboriginal community and Aboriginal communitycontrolled organisations; (2) an under-appreciation of the existing and competing patient commitments with respect to general health and wellbeing, and medical treatment to enable all study commitments; (3) most study staff employed from outside the region; (4) potential participants not having the required number of teeth; (5) invasive intervention that involved travel to, and time at, a dental clinic. A more feasible research model, which addresses the divergent needs of participants, communities and service partners is required. This type of approach, with sufficient time and resourcing to ensure ongoing engagement, partnership and collaboration in co-design throughout the conduct of research, challenges current models of competitive, national research funding. Keywords:  Periodontal disease, Chronic kidney disease, Aboriginal Australian Introduction Aboriginal Australians experience high rates of chronic kidney disease (CKD) [1]. Recent estimates from Central Australia suggest that more than 40 percent of Aboriginal Health Service attendees have micro or macroalbuminuria and 40 percent have reduced eGFR [2]. Dialysis for end stage kidney disease (ESKD) is the leading cause of hospitalisation for Aboriginal Australians, comprising *Correspondence: [email protected] 1 Australian Research Centre for Population Oral Health, University of Adelaide Dental School, University of Adelaide, Adelaide, SA, Australia Full list of author information is available at the end of the article

42 percent of all admissions [3]. Aboriginal Australians with ESKD are younger than their non-Aboriginal counterparts and many have co-existing chronic health conditions [4]. Periodontal disease is inflammation of the tissues surrounding teeth and results from a complex interplay between bacteria and host risk factors. Periodontal organisms flourish in the presence of inflammation, enabling them to invade host tissues and to gain direct access to th