Transcript
Announcer:
You’re listening to Clinician’s Roundtable on ReachMD. On this episode, Dr. Sayna Norouzi will discuss patient-centered communication strategies for IgA nephropathy. Dr. Norouzi is an Associate Professor of Medicine and Clinical Nephrologist at Loma Linda University Medical Center in California. She's also the Founder and Director of the Glomerular Diseases Clinic at Loma Linda and serves as the Director of the GlomCon Glomerular Diseases Fellowship Program. Let’s hear from her now.
Dr. Norouzi:
I think one of the main barriers that we have for our patients is that these patients are really young. They're not patients that are coming in and saying, "I'm not able to work anymore." They might have some fatigue. They might have some symptoms, sometimes some edema, depending on the degree of CKD, of course, as well.
But majority of patients, when they show up, are in their 20s, 30s, and even 40s. They're still young, they go to work, they are raising a family, and they do not want to be sick. They don't want to take multiple medications. So I think it's truly an art to talk to these patients and discuss the prognostic values that we have for them.
I actually have the RaDaR study data in my clinic that I show them, and I say, "Look at this. These are the years that you have, and in 10 or 15 years, you might end up on dialysis, because you are in the category of patients with this much proteinuria, and this is your kidney function at the time."
So I try to explain it in as simple words as much as possible. But I can tell you, having access to ChatGPT and internet these days, a lot of my patients, when they come in, already know a lot about their disease, and they even know about the newer options that are out there. And they just want to know which option is going to be the best for them.
Going home with multiple medications, it's not happy news for them. But I always tell them, “You have a lot of options.” Six years ago, in my clinic, when my patients were coming in, we did not have any of these options. And even though we knew that these patients might end up on dialysis or transplant, we couldn't do much, and we weren't optimistic about the possible outcomes. “I know that you're taking multiple medications, and you have to be careful about the possible side effects, but the good part is there is possible treatment for you that can delay complications for you. We have a good understanding of their safety data so far, and you have access to these new medications as well.”
So I try to explain to them that even for the safety data, I understand that we need longer term data on that. But so far, from the clinical trials, most of these medications have a really good safety profile as well, compared for example, to systemic corticosteroid that we used historically for patients with high-risk IgA nephropathy.
I think that kind of conversation and how you establish that relationship with your patients is really important. And actually, it helps them to be more compliant with their medications and be more compliant with their follow-up visits. And maybe it's not that hard to tell them that we have the same goal, we want to prevent complications for you, these are your options, and let's work together to see if we can put you in remission.
Announcer:
That was Dr. Sayna Norouzi explaining how to counsel patients with IgA nephropathy on treatment options and long-term outcomes. To access this and other episodes in our series, visit Clinician’s Roundtable on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
