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Kidney Week

Abstract: TH-PO328

Home Therapy New Patient Experience Survey Assessment for New Home Dialysis Patients

Session Information

  • Home Dialysis - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Blankenship, Derek M., Global Medical Office, Fresenius Medical Care, Waltham, Massachusetts, United States
  • Wadhwa, Namrata, Care Delivery, Fresenius Medical Care, Waltham, Massachusetts, United States
  • Green, Judy, Care Delivery, Fresenius Medical Care, Waltham, Massachusetts, United States
  • Dharmadhikari, Aakash M., Care Delivery, Fresenius Medical Care, Waltham, Massachusetts, United States
  • Willetts, Joanna, Global Medical Office, Fresenius Medical Care, Waltham, Massachusetts, United States
  • Usvyat, Len A., Global Medical Office, Fresenius Medical Care, Waltham, Massachusetts, United States
  • Maddux, Franklin W., Global Medical Office, Fresenius Medical Care, Waltham, Massachusetts, United States
Background

Home hemodialysis (HHD) and peritoneal dialysis (PD) patients with an email receive a Home Therapy New Patient Experience Survey (PES) 21 days after initiating treatment. Feedback gathered from the survey is used to identify and address problems early and patients are referred for clinical support as needed. The aim is to listen and respond to patient feedback early in their journey, improve experience and clinical and health outcomes, thereby increasing home dialysis retention rates. The purpose of this study is to assess these aims.

Methods

11,793 PD and 2,156 HHD patients who received a PES between 5/1/19 and 2/28/21 are compared to matched patients of the same modality who did not receive a survey. Controls were chosen using propensity score matching with confounders including month of first order occurrence, age, gender, race, ethnicity, state, urban/rural, BMI, residual kidney function, vintage, vascular access type, comorbidities, and primary insurance. Outcomes include 1 year follow-up status (maintained modality, in-center HD [ICHD], other home modality, transfer, transplant, or death), and hospitalizations. Analysis included Cox proportional hazards model and bootstrap methods with =0.05.

Results

PD:
Compared to controls, PES patients were 15% less likely to switch to ICHD, 25% more likely to have a transplant, and had fewer hospitalizations. Not statistically significant but directionally positive, survey patients were 21% more likely to switch to HHD, 16% less likely to transfer to a non-Fresenius clinic, and had fewer days hospitalized.
HHD:
Compared to controls, survey patients were 49% less likely to switch to ICHD, 71% less likely to switch to PD, 48% less likely to transfer to a non-Fresenius clinic and had fewer frequency and duration of hospitalizations. Not statistically significant but directionally positive, survey patients were 34% more likely to have a transplant.

Conclusion

This study provided evidence that proactively and consistently listening to patients to understand their experience on home dialysis and taking action based on their feedback, often in real-time, can help prevent issues escalating, improve patients’ overall health outcomes, increase patient retention on home and their overall loyalty to Fresenius Kidney Care as a dialysis provider.