Missed Treatments: Dr. Francesca Tentori Discusses Patient Perspectives and Tailored Care Approaches
At the American Society of Nephrology (ASN) Kidney Week this year, DaVita Clinical Research’s study “Exploring Patient Perspectives on Reasons for Missing Dialysis Treatments” shed vital light on this challenge.
The research reveals that 63% of missed treatments stem from acute, same-day circumstances — most often health symptoms rather than logistical or scheduling conflicts.
In this Q&A, Dr. Francesca Tentori, vice president of outcomes research and patient empowerment for DaVita and an author on the study, shares what these patient-reported insights mean, including how the right approaches to patient education, care coordination and communication can help turn vulnerable moments into proactive interventions.
Explore the study results here.
What gap in kidney care prompted this study?
Dr. Tentori: We have long recognized that missed dialysis treatments correlate with higher morbidity, hospitalizations and other negative health outcomes.
Our team sought to examine the patients’ perspective and experience by surveying a large cohort of patients who had skipped at least one dialysis session over the course of a month. This approach allowed us to uncover the real, lived reasons behind missed sessions, understand how patients perceive the risks of skipping treatment and evaluate how teams can respond to help patients get back on track.
What did the study learn about patients’ experiences of missing treatments?
Dr. Tentori: Among 224 responders nearly two-thirds (63%) of missed treatments were unplanned, and acute health concerns were the single largest driver, accounting for nearly half (48%) of missed treatments.
While nearly half of the patients surveyed worried that missing treatment would harm their health, their concerns didn’t correlate with a higher likelihood of rescheduling their treatment. They were most concerned about the symptoms they would experience. Only about one-third of patients proactively intended to make up for their missed treatment.
That disconnect is where the care team can make an incredible difference. Our findings clearly indicated that proactive outreach from the dialysis care team resulted in a higher likelihood of rescheduling the treatment.
How can this help care teams shift conversations to promote proactive care?
Dr. Tentori: It’s critical we continue to educate patients on how missed treatments affect their health. What this study reinforces, though, is why we’re focused on building workflows centered on proactive, empathetic engagement with patients.
It’s about not only sharing with patients why missing treatments can be harmful but also making sure they know how to set up a replacement treatment. It’s about not only recording in their medical record when someone doesn’t show up but also initiating outreach to find out why and set up a rescheduled treatment. A call to someone when they don’t show up serves as a clinical check-in as well as an opportunity to work with the patient to reassure them and help them find an opening to come in and get the treatment they need.
Ultimately, our mission is to ensure that every patient has access to the support systems and flexibility they need in their everyday, lived experiences.