Journal Watch - Home Dialysis
Home Dialysis Barriers Examined (Again)
Since the NKF-KDOQI is a latecomer to the home dialysis party (at least for home HD), they started at the beginning with a conference identifying barriers to starting and keeping patients at home. Not surprisingly, cursory education, and lack of exposure to home options or support for care partners were implicated.
Read the abstract » | (added 01/11/2019)
Driving Home Dialysis Takes More Than Money
Are financial incentives enough to change nephrologist practice to favor home therapies? Only a little, finds a comprehensive literature review and an international workshop. Other levers, such as the framework of funding for clinics, nephrologist belief in home treatments, and direct costs to patients (e.g., utilities) may play a role as well.
Read the abstract » | (added 08/13/2018)
Who Matters Most for Modality Choice: Clinicians or Patients?
New Zealand has one of the highest rates of home dialysis use in the world—and they still believe there is room for improvement. An online study of all NZ dialysis clinics coupled with a measure of “decisional power” aimed to see who had the most influence on modality choice. While respondents believed that predialysis nurses were most influential, nephrologists still held the most decisional power—and a one point increase in nephrologist decisional power drove a 6.1% rise in home dialysis use.
Read the abstract » | (added 12/14/2017)
Barriers to Intensive HD in Pediatrics
Why don’t more people choose intensive hemodialysis? Responses to a survey by 134 of the 221 pediatric dialysis centers in the International Pediatric Dialysis Network found that more than 2/3 were aware of evidence supporting the benefits of intensive HD and half believed it produced the best outcomes (just 2% favored conventional HD). Key barriers included lack of funding and staff, with lack of expertise and motivation as minor factors. Read the abstract.
Read the abstract » | (added 11/13/2017)