Abstract: SA-PO1086
Global Home Dialysis Therapy Perceptions and Practices: An International Survey
Session Information
- Vascular Access - II
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 702 Dialysis: Home Hemodialysis
Authors
- Bennett, Paul N., Satellite Healthcare, San Jose, California, United States
- Eilers, Denise, United Township Area Career Center, Davenport, Iowa, United States
- Yang, Fang, Satellite Healthcare, San Jose, California, United States
- Price Rabetoy, Christy A., ANNA, Piney Flats, Tennessee, United States
Background
Home hemodialysis (HHD) and peritoneal dialysis (PD) prevalence varies throughout the world. Home dialysis policies and clinician knowledge affect home dialysis prevalence. The goal of this study was to identify international policies and perceptions exploring: reimbursement of patient costs; telehealth; staff home visits; solo dialysis and patient training.
Methods
A 13 item web-based questionnaire was distributed to home therapy program clinicians in the 30 highest home dialysis prevalent nations worldwide. Questions explored patient reimbursement, telehealth, patient training, solo dialysis, home and clinic visit frequency. IRB approved surveys were independently translated into 9 languages with translation validation by an external translation service.
Results
395 respondents from 30 nations using 7 different languages responded. 64% were aligned with combined HHD and PD programs, 29% PD only and 7% HHD only. 29% of programs had less than 20 patients, 30% had 20 to 50 patients, 22% had 51 to 100 patients and 19% had greater than 100 patients. 31% of all programs reported patient costs reimbursement, with non-US programs much more likely to report reimbursement than US programs (US 11%, non-US programs 59%, χ2=93.6, p<0.0001). Telehealth use was low throughout the world (23% prevalence), contrasting with 83% of respondents agreeing telehealth would improve home dialysis care. 31% of all programs enabled flexible training out of work hours. 72% of US clinicians agreed that monthly clinic visits were needed in comparison to 44% of non-US clinicians (χ2 = 83.7, p<0.0001). 31% of respondents agreed that dialysis partners are always required for home dialysis.
Conclusion
Global variation in home therapy protocols, knowledge and attitudes exist. Telehealth, cost reimbursement, training flexibility and acceptance of solo dialysis is low. Addressing these hurdles to home dialysis may increase home dialysis growth.