Perspectives and Experiences of Veterans Receiving Kidney Medically Tailored Meals in CKD

Objectives: Veterans living with CKD often endure disproportionate burdens and challenges related to medical dietary adherence. Medically tailored meals (MTMs) are formulated by health or nutrition professionals to meet complex nutritional needs in chronic illnesses like CKD. The objective of this study is to understand the experiences of Veterans with CKD utilizing MTMs. Methods: We interviewed 23 Veterans about diet and nutrition experiences in the context of CKD. For this report, we focus on a subset of 8 Veterans interviewed between 06/2023 to 02/2024 from the Eastern Colorado VA Healthcare System receiving MTMs within the past year and with stages 3b-5 CKD. A semi-structured interview guide was used to gather MTM perspectives. Rapid matrix analysis was conducted to identify patterns inductively and deductively across the data. Results: Emergent themes and experiences from Veterans are: 1) Barriers and facilitators to the MTM referral process: The importance of awareness of MTM resources (e.g., word of mouth) and simple MTM referral processes (e.g., physician, nutrition, or friends) as a facilitator. 2) MTM program and delivery experiences: The importance of good quality MTM service and staff along with consistent deliveries; opportunities for social eating. 3) MTM quantity or portions: Some MTM programs had misalignment with Veteran quantity or portion needs (e.g., too much or too little). 4) MTM quality and preferences: Veterans shared both positive and negative experiences. Positive aspects included: satisfactory meal quality, satiation, and variety that align with preferences) and negative aspects included (skepticism on medical diet tailoring, monotony or repetitiveness, and dislikes of texture, cuisine, flavoring, and spices). 5) Best MTM practices: Support for receiving MTM deliveries; the need for detailed nutritional content or reassurance through labeling type of medical tailoring; consideration of food storage capacity; customization or choice with MTMs, breakfast options, and other supplemental items (e.g., seasonings, condiments). Conclusions: This study reveals many crucial areas of consideration for MTMs within the Veteran population and future MTM interventions, such as choice, customization, or personalization, along with increased MTM awareness. Funding Sources: None.