Abstract: SA-PO1071
Barriers to Home Hemodialysis in Saskatchewan Canada: Results from a Provincial Survey
Session Information
- Home Hemodialysis
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
- Diebel, Lucas, College Of Medicine, University of Saskatchewn, Regina, Saskatchewan, Canada
- Day, Christine, Saskatchewan Health Authority, Regina, Saskatchewan, Canada
- Shah, Sachin, St Pauls Hospital, Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada
- Jafari, Maryam, RQHR- Research and Performance Support, Regina, Saskatchewan, Canada
- Prasad, Bhanu, Regina General Hospital, Saskatchewan Health Authority, Regina, Saskatchewan, Canada
Background
Home hemodialysis (HHD) offers similar, and perhaps even superior clinical outcomes to in-center hemodialysis (HD) at a fraction of the cost. HHD remains underutilized as remote HD patients in Saskatchewan often relocate or travel hundreds of kilometers weekly in order to receive dialysis related care. The purpose of this study was to determine the barriers to receiving HHD in our province.
Methods
We conducted a cross sectional survey of in center HD patients across the province of Saskatchewan. 740 in center HD patients (two academic sites, 7 satellite units) were approached by study coordinators. 421 patients (n=268 in the main units and n=153 in the satellite units) agreed to participate in the study. A five-point Likert scale survey was created to identify barriers to HHD with questions addressing HHD awareness and knowledge, accessibility, home constraints, impact on family members, and risks/fears/beliefs surrounding HHD. Responses were anonymous and tabulated using a data collection tool.
Results
Only 76% of patients were aware of HHD. 46% of patients felt they had no understanding of the benefits or risks of HHD. Despite only 8% of patients being told they were unsuitable for HHD by their nephrologist, only 28% had ever considered it as a treatment option. Other prominent barriers to HHD were: satisfaction with in center HD (76%), medical supervision during HD (76%), opportunity to socialize with in center HD patients (73%), increase in utility payments (54%), and fear of having a major health event at home (51%). Other home constraints (space, inability to make modifications to the home) also figured prominently (35%).
Conclusion
In this study, we identified patient specific barriers to HHD in a prevalent cohort of HD patients. Several barriers were identified with a few consistent themes being identified, including deficiencies in knowledge and awareness, home constraints, and perceived benefits of in center care (satisfaction with current care, socializing with patients and staff, and fear of a catastrophic event at home). The most frequently reported knowledge barrier was a lack of understanding of the benefits and risks of HHD. While the study does not reflect views of all the patients, this information will be valuable in designing an educational program to improve adoption of HHD within our province.