Abstract: FR-PO770
Identifying a Core Vascular Access Outcome for All Trials in Hemodialysis: An International Survey with Patients and Health Professionals
Session Information
- Hemodialysis: Vascular Access - II
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Dialysis
- 603 Hemodialysis: Vascular Access
Authors
- Viecelli, Andrea K., Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Howell, Martin, University of Sydney, Sydney, New South Wales, Australia
- Tong, Allison, University of Sydney, Sydney, New South Wales, Australia
- Craig, Jonathan C., University of Sydney, Sydney, New South Wales, Australia
- Johnson, David W., Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Hawley, Carmel M., Princess Alexandra Hospital, Brisbane, Queensland, Australia
Background
Vascular access is an essential component for the care of patients requiring hemodialysis, yet clinical trials report a large and diverse range of vascular access outcomes that often cannot readily be compared across trials and have no clear relevance to patients and clinicians. This survey aims to identify a core outcome for vascular access, with the expectation that this will be measured and reported in all trials involving patients requiring hemodialysis, based on the shared priorities of patients/caregivers and health professionals.
Methods
Based on a systematic review, qualitative research and meetings with vascular access experts, 12 vascular access outcomes were included in an online survey conducted in English, Chinese, Spanish and Malay. Participants rated the absolute importance of outcomes using a 9-point Likert scale (7-9 being critically important), and the relative importance was determined by a Best-Worst Scale (BWS) using multinomial logistic regression.
Results
The survey was completed by 772 participants (187 [24%] patients/caregivers and 585 [76%] health professionals) from 58 different countries. Across both groups, the top two outcomes were function (mean 8.4, top 1 on BWS) and infection (mean 8.1, top 2 on BWS). There was consistency in the prioritization of outcomes between both groups but health professionals rated outcomes overall higher than patients/caregivers (mean differences ranging from 0.09 for interference with activities to 1.3 for access maturation) with the exception of aneurysms which was ranked higher by patients/caregivers (mean difference 1.1, top 3 vs 7 on BWS).
Conclusion
For patients/caregivers and health professionals, there was consensus on the primary importance of vascular access function. A core outcome measure for function will now be developed to improve the consistency and relevance of vascular access outcomes reported in trials in hemodialysis.
Funding
- Government Support - Non-U.S.