Abstract: FR-PO0520
Promoting Self-Sufficiency in Home Hemodialysis: A Single Center's Journey to Improved Adoption and Therapy Retention
Session Information
- Home Dialysis: Clinical Epidemiology
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Author
- Bermudez, Maria, Geisinger Medical Center, Danville, Pennsylvania, United States
Group or Team Name
- Home Dialysis Team, DaVita, Selinsgrove, PA.
Background
Despite challenges posed by inadequate support, care partner burnout, self-care skill gaps, and fear of self-cannulation, a significant proportion of patients demonstrate capacity for solo HHD, as shown in a large survey where 50% admitted to have mastered it within 3 months. Additionally, 16% of patients with care partners opted for independence at least sometimes, and 15% dialyzed solo. Patients prioritize autonomy, deeming rare complications manageable, which underscores the critical role of promoting self-management skills. This approach is particularly important given the association between failed HHD therapy and poor patient outcomes.
Methods
Our quality improvement program empowers patients to acquire self-care skills, including self-cannulation. We used the PATH-D tool to assess task distribution and developed a plan to promote independence through education, partnership with vascular surgeons, and tailored training to build patient confidence and autonomy.
Results
Cannulation was found to be the primary task requiring assistance. Key outcomes included: 2 patients transitioning to solo HHD despite having a partner, 1 patient transitioning to solo HHD after losing their partner, nealry 50% patients (15/33) achieving independence performing >80% of tasks, 33% of patients (11/33) self-cannulating despite having a care partner, 1 starting solo HHD optimally.
Conclusion
Our program has successfully shifted our approach from default assisted HHD to various degrees of unassisted HHD and demonstrates the potential for proactive promotion of self-sufficiency to improve HHD sustainability. Further follow-up will be valuable to assess long-term outcomes, identify predictors of successful autonomy, and refine our approach to maximize benefits for patients