Special Home Dialysis Edition:
In Case You Missed It! August 2024
This month’s newsletter highlights a selection of recently published peer-reviewed home dialysis articles centered around:
- Identifying Challenges
- Finding Solutions
- Getting and Keeping Patients Home
Home Dialysis Recent Findings
Identifying Major Barriers to Home Dialysis (The IM-HOME Study): Findings From a National Survey of Patients, Care Partners, and Providers
A 7-member advisory board, comprised of patients, care partners, and dialysis providers collaborated to devise lists of barriers perceived by patients/care partners and providers (clinicians, nurses, and clinic staff), respectively. The authors then used these lists to develop a survey that was distributed to patients/care partners and providers via the American Association of Kidney Patients and the National Kidney Foundation. 522 respondents (289 patients/care partners; 233 providers) ranked their top 3 barriers from the list the advisory board assembled, and qualitatively (open-ended) described their own perceived barriers. The authors note a lack of overlap between patient/care partner and provider perceived barrier themes and subthemes. Where there were overlapping themes, it is interesting to read the different interpretations of these themes from patient/care partners versus providers.
Clinical Outcomes of a Novel Multidisciplinary Care Program in Advanced Kidney Disease (PEAK)
The Rogosin Institute implemented the Program for Education in Advanced Kidney Disease (PEAK), a multidisciplinary care (MDC) model, from May 2015 to February 2020. The program enrolled 489 late-stage chronic kidney disease (CKD) patients to investigate whether a structured framework, supported with an expanded MDC team, regular care plan meetings, clinical risk prediction, and patient dashboards, could improve optimal transitions to ESKD compared to national and regional averages. Optimal transitions were defined as starting in-center hemodialysis with a fistula or graft, starting on home dialysis, or preemptive transplant. In this article, the authors describe the composition of the PEAK care team, the PEAK process flow, and results.
The Integrated Care Model: Facilitating Initiation of or Transition to Home Dialysis
Investigators propose a 6-step approach, primarily adapted from Blake et al.,1 and informed by several other successful published strategies, to maximize the number of patients on home dialysis. The authors’ proposed framework allows care teams to measure missed opportunities and success rates at each step to track effectiveness in educating, establishing, and keeping patients on their preferred end-stage kidney disease modality choice.
Description and Outcomes of a Staff-Assisted Peritoneal Dialysis Program in the United States
In an initial pilot in two centers, later expanded to 16 centers, Satellite Healthcare tested whether using Patient Care Technicians (PCTs) for limited time periods in a staff-assisted peritoneal dialysis (PD) program, was operationally feasible, and whether it could help transition and maintain patients on independent PD. A total of 121 patients were referred to the pilot program and subsequent expansion. Of the 73 patients who completed training, 93% transitioned home on PD without staff assistance.
APM5124 Rev.A
