Perspectives of patients and clinicians on reproductive healthcare and autosomal dominant polycystic kidney disease

IntroductionFamily planning and reproductive care are essential yet complex aspects of lifecycle management for individuals with Autosomal Dominant Polycystic Kidney Disease (ADPKD), given the potential genetic transmission and pregnancy-related complications. This qualitative study studied the experiences and perspectives of patients with ADPKD and clinicians to identify areas for potential improvement in reproductive lifecycle care.MethodsFocus group discussions were conducted in the Netherlands with patients with ADPKD, both men and women, who had children through varied reproductive choices, and clinicians, including (pediatric) nephrologists, obstetric gynecologists and geneticists. Thematic analysis, utilizing a grounded theory approach, was performed on verbatim transcriptions of recordings, followed by consensus discussions to finalize themes.ResultsNine focus groups involving 31 participants (16 patients and 15 physicians) identified six key themes. These included the need for timely and comprehensive information dissemination from puberty on, understanding patient-specific decision-making factors, improving tailored psychosocial guidance and communication, the need for systematic efforts to take care of missed (minor) at-risk patients, addressing inequities in access to care, and improving multidisciplinary collaboration.ConclusionsThis study represents the first qualitative study of patient and physician perspectives on reproductive lifecycle care for ADPKD. We present valuable insights into factors influencing patients' reproductive decision-making, a comprehensive comparison between the perspectives of patients and clinicians on family planning, and follow-up care of minors at risk for ADPKD, and recommendations for enhancing overall care quality. Incorporating these insights into clinical care could enhance patient-centered care and foster interdisciplinary collaborations to further improve the quality of reproductive healthcare services for individuals with ADPKD.