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Abstract: PO0949

Evaluation and Measurement Properties of a Patient-Reported Experience Measure for Home Dialysis

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Rivara, Matthew B., University of Washington, Seattle, Washington, United States
  • Prince, David K., University of Washington, Seattle, Washington, United States
  • Leuther, Kerstin, Satellite Healthcare, San Jose, California, United States
  • Hussein, Wael F., Satellite Healthcare, San Jose, California, United States
  • Schiller, Brigitte, Satellite Healthcare, San Jose, California, United States
  • Mehrotra, Rajnish, University of Washington, Seattle, Washington, United States
  • Edwards, Todd C., University of Washington, Seattle, Washington, United States
  • Patrick, Donald, University of Washington, Seattle, Washington, United States
Background

There are no validated patient-reported experience measures (PREMs) for use among patients undergoing home dialysis in the United States. We sought to test the home dialysis care experience (Home-DCE) survey, a newly developed 26-item PREM, in a sample of patients from 30 dialysis facilities operated by a single dialysis organization in the United States.

Methods

Using mail and phone survey modalities, we approached 1372 patients treated with peritoneal dialysis (PD) or home hemodialysis (HD) for participation. Using results from completed Home-DCE surveys, we hypothesized multi-item scales and used factor analysis to assess model fit. We assessed scale internal consistency reliability, and assessed floor and ceiling effects for scales and individual items. We evaluated test-retest reliability using intra-class correlation coefficients (ICCs) in a subset of patients who completed the Home-DCE twice. Finally, we evaluated patient demographic and home dialysis facility characteristics (nurse-to-patient ratio, hospitalization rate, star rating, and census) associated with Home-DCE scores.

Results

Overall, 495 eligible patients completed at least one survey (response rate 36%), including 399 treated with PD and 88 treated with home HD; 7 did not indicate their modality. Of these, 49 completed the Home-DCE in Spanish and 61 completed a second survey within 30 days. Analyses supported one 12-item composite scale with high internal consistency reliability: Quality of Home Dialysis Care and Operations (Cronbach alpha = 0.85). This scale was strongly correlated with overall staff rating (r = 0.73) and overall center rating (r = 0.70). ICCs in the test-retest population were 0.73 for the Quality scale, 0.88 for the overall staff rating, and 0.9 for the overall center rating. Patient demographic and dialysis facility characteristics were not consistently associated with Quality scale scores or overall staff or center ratings.

Conclusion

The Home-DCE includes one statistically robust multi-item scale and two global rating scores, and is an informative tool to evaluate patient-reported experience of care for home dialysis. Additional studies are needed to further evaluate the Home-DCE among different dialysis care providers, and to assess the feasibility of electronic administration.

Funding

  • Private Foundation Support