Patient-identified health service transformation

an Aboriginal patient's experience with extensive chronic tinea corporis and delayed kidney transplantation wait-listing

Jaqui Hughes, Renae Kirkham, O Aye Min, Heather Hall, Bart Currie, Sandawana William Majoni

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Extensive chronic tinea corporis (EC-TC) is common in people living in tropical environments and in individuals living with diabetes and chronic kidney disease (CKD). However, adults with end-stage kidney disease (ESKD) who seek kidney transplant (KTx) wait-listing require an infection-free medical clearance. Australian clinical care guidelines suggest tinea corporis is cured by antifungal treatment within 2 weeks in the general population, but there are no specific treatment guidelines for adults with severely reduced kidney function who require haemodialysis.

Aim: To describe factors contributing to delayed KTx wait-listing in a patient with EC-TC.

Method: We undertook a case review to address both treatment response for EC-TC for a 43-year-old female with a history of diabetic nephropathy following haemodialysis initiation, and the time it took for her to achieve KTx wait-listing. Follow-up interviews with the client and supporting clinicians were completed in order to learn more about individual perspectives of care.

Results: We observed cure of EC-TC on day 394, and achievement of KTx wait-listing on day 496. The treatment algorithm used to achieve cure involved extended courses of oral terbinafine (250 mg post-dialysis three times weekly, partial response) and oral fluconazole (cure within 3 weeks; 100 mg weekly at dialysis). Holistic care during KTx workup was valued by the patient.

Conclusion: Delayed cure of EC-TC contributed to delayed KTx wait-listing. The in-depth interviews therefore identified healthcare innovations to assist systematic identification and treatment initiation for EC-TC. Furthermore, specific research to improve the treatment response is recommended."
Original languageEnglish
Pages (from-to)92-96
Number of pages5
JournalRenal Society of Australasia Journal
Volume15
Issue number3
Publication statusPublished - Nov 2019

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Tinea
Kidney Transplantation
Health Services
terbinafine
Renal Dialysis
Dialysis
Therapeutics
Guidelines
Interviews
Kidney
Fluconazole
Diabetic Nephropathies
Chronic Renal Insufficiency
Chronic Kidney Failure
Delivery of Health Care
Transplants
Infection
Research
Population

Cite this

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title = "Patient-identified health service transformation: an Aboriginal patient's experience with extensive chronic tinea corporis and delayed kidney transplantation wait-listing",
abstract = "Extensive chronic tinea corporis (EC-TC) is common in people living in tropical environments and in individuals living with diabetes and chronic kidney disease (CKD). However, adults with end-stage kidney disease (ESKD) who seek kidney transplant (KTx) wait-listing require an infection-free medical clearance. Australian clinical care guidelines suggest tinea corporis is cured by antifungal treatment within 2 weeks in the general population, but there are no specific treatment guidelines for adults with severely reduced kidney function who require haemodialysis.Aim: To describe factors contributing to delayed KTx wait-listing in a patient with EC-TC.Method: We undertook a case review to address both treatment response for EC-TC for a 43-year-old female with a history of diabetic nephropathy following haemodialysis initiation, and the time it took for her to achieve KTx wait-listing. Follow-up interviews with the client and supporting clinicians were completed in order to learn more about individual perspectives of care.Results: We observed cure of EC-TC on day 394, and achievement of KTx wait-listing on day 496. The treatment algorithm used to achieve cure involved extended courses of oral terbinafine (250 mg post-dialysis three times weekly, partial response) and oral fluconazole (cure within 3 weeks; 100 mg weekly at dialysis). Holistic care during KTx workup was valued by the patient.Conclusion: Delayed cure of EC-TC contributed to delayed KTx wait-listing. The in-depth interviews therefore identified healthcare innovations to assist systematic identification and treatment initiation for EC-TC. Furthermore, specific research to improve the treatment response is recommended.{"}",
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Patient-identified health service transformation : an Aboriginal patient's experience with extensive chronic tinea corporis and delayed kidney transplantation wait-listing. / Hughes, Jaqui; Kirkham, Renae; Min, O Aye; Hall, Heather; Currie, Bart; Majoni, Sandawana William.

In: Renal Society of Australasia Journal, Vol. 15, No. 3, 11.2019, p. 92-96.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Patient-identified health service transformation

T2 - an Aboriginal patient's experience with extensive chronic tinea corporis and delayed kidney transplantation wait-listing

AU - Hughes, Jaqui

AU - Kirkham, Renae

AU - Min, O Aye

AU - Hall, Heather

AU - Currie, Bart

AU - Majoni, Sandawana William

PY - 2019/11

Y1 - 2019/11

N2 - Extensive chronic tinea corporis (EC-TC) is common in people living in tropical environments and in individuals living with diabetes and chronic kidney disease (CKD). However, adults with end-stage kidney disease (ESKD) who seek kidney transplant (KTx) wait-listing require an infection-free medical clearance. Australian clinical care guidelines suggest tinea corporis is cured by antifungal treatment within 2 weeks in the general population, but there are no specific treatment guidelines for adults with severely reduced kidney function who require haemodialysis.Aim: To describe factors contributing to delayed KTx wait-listing in a patient with EC-TC.Method: We undertook a case review to address both treatment response for EC-TC for a 43-year-old female with a history of diabetic nephropathy following haemodialysis initiation, and the time it took for her to achieve KTx wait-listing. Follow-up interviews with the client and supporting clinicians were completed in order to learn more about individual perspectives of care.Results: We observed cure of EC-TC on day 394, and achievement of KTx wait-listing on day 496. The treatment algorithm used to achieve cure involved extended courses of oral terbinafine (250 mg post-dialysis three times weekly, partial response) and oral fluconazole (cure within 3 weeks; 100 mg weekly at dialysis). Holistic care during KTx workup was valued by the patient.Conclusion: Delayed cure of EC-TC contributed to delayed KTx wait-listing. The in-depth interviews therefore identified healthcare innovations to assist systematic identification and treatment initiation for EC-TC. Furthermore, specific research to improve the treatment response is recommended."

AB - Extensive chronic tinea corporis (EC-TC) is common in people living in tropical environments and in individuals living with diabetes and chronic kidney disease (CKD). However, adults with end-stage kidney disease (ESKD) who seek kidney transplant (KTx) wait-listing require an infection-free medical clearance. Australian clinical care guidelines suggest tinea corporis is cured by antifungal treatment within 2 weeks in the general population, but there are no specific treatment guidelines for adults with severely reduced kidney function who require haemodialysis.Aim: To describe factors contributing to delayed KTx wait-listing in a patient with EC-TC.Method: We undertook a case review to address both treatment response for EC-TC for a 43-year-old female with a history of diabetic nephropathy following haemodialysis initiation, and the time it took for her to achieve KTx wait-listing. Follow-up interviews with the client and supporting clinicians were completed in order to learn more about individual perspectives of care.Results: We observed cure of EC-TC on day 394, and achievement of KTx wait-listing on day 496. The treatment algorithm used to achieve cure involved extended courses of oral terbinafine (250 mg post-dialysis three times weekly, partial response) and oral fluconazole (cure within 3 weeks; 100 mg weekly at dialysis). Holistic care during KTx workup was valued by the patient.Conclusion: Delayed cure of EC-TC contributed to delayed KTx wait-listing. The in-depth interviews therefore identified healthcare innovations to assist systematic identification and treatment initiation for EC-TC. Furthermore, specific research to improve the treatment response is recommended."

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VL - 15

SP - 92

EP - 96

JO - Renal Society of Australasia Journal

JF - Renal Society of Australasia Journal

SN - 1832-3804

IS - 3

ER -