Abstract: SA-PO1072
Differences in Perceptions of Home-Based Dialysis Therapies Among the Renal Multidisciplinary Team
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
- Poinen, Krishna, University of British Columbia, Vancouver, British Columbia, Canada
- Canney, Mark, University of British Columbia, Vancouver, British Columbia, Canada
- Er, Lee, BC Renal, Vancouver, British Columbia, Canada
- Copland, Michael A., University of British Columbia, Vancouver, British Columbia, Canada
Background
Patients with end stage renal disease are encouraged to pursue home-based dialysis therapy (HDT) with the aims of improving quality of life, increasing patient autonomy and reducing the cost to the health care system. In the multidisciplinary setting, patients have exposure to nurses, clinicians and allied health staff, all of whom may influence a patient’s modality choice. We aimed to evaluate the perceptions of HDT amongst multidisciplinary team members and identify avenues for further education
Methods
An electronic survey was distributed over a 6-week period to 695 non-transplant multidisciplinary team members across multiple renal centers in British Columbia, Canada. The survey contained questions about work environment, patient/system factors in choosing HDT, perceived knowledge of HDT and the need for further education. Results were stratified by 5 categories of respondent: nephrologists, nurses in 3 clinical areas (facility hemodialysis, HDT, pre-dialysis), and allied health (pharmacists, social workers, dieticians)
Results
A total of 334 respondents were included (48% response rate). The majority of respondents in all categories stated that they would choose HDT if they were ever to require dialysis. The majority also recommended that a higher proportion of patients should receive HDT, especially patients who work or study. Facility nurses were believed to have the least impact on a patient’s choice of modality, yet they also perceived themselves as key patient educators. Facility and HDT nurses favored in-center dialysis and HDT respectively for patients with lower socioeconomic status, lower education or a language barrier. All respondents acknowledged the benefits of HDT for cost-savings and improved patient survival. The majority of nurses and allied health staff felt the need for further education in HDT, favoring practical over knowledge-based educational opportunities
Conclusion
The majority of the renal multidisciplinary team members would welcome increased uptake of HDT due to benefits on the patient and healthcare system level. Nurses differed substantially in their perceptions of modifiable barriers to HDT depending on their primary area of work. Further HDT education has the potential to bridge these gaps and help patients make informed decisions about their dialysis modality