TY - JOUR
T1 - Australian Workshops on Patients’ Perspectives on Hemodialysis and Incremental Start
AU - Hegerty, Katharine
AU - Jaure, Allison
AU - Scholes-Robertson, Nicole
AU - Howard, Kirsten
AU - Ju, Angela
AU - Evangelidis, Nicole
AU - Wolley, Martin
AU - Baumgart, Amanda
AU - Johnson, David W.
AU - Hawley, Carmel M.
AU - Reidlinger, Donna
AU - Hickey, Laura
AU - Welch, Alyssa
AU - Cho, Yeoungjee
AU - Kerr, Peter G.
AU - Roberts, Matthew A.
AU - Shen, Jenny I.
AU - Craig, Jonathan
AU - Krishnasamy, Rathika
AU - Viecelli, Andrea K.
AU - INCremental dialysis to improve Health outcomes people starting Hemodialysis (INCH-HD) investigators
PY - 2023/3
Y1 - 2023/3
N2 - Introduction: Most patients with kidney failure commence and continue hemodialysis (HD) thrice weekly. Incremental initiation (defined as HD less than thrice weekly) is increasingly considered to be safe and less burdensome, but little is known about patients’ perspectives. We aimed to describe patients’ priorities and concerns regarding incremental HD. Methods: Patients currently, previously, or soon to be receiving HD in Australia participated in two 90-minute online workshops to discuss views about HD focusing on incremental start and priorities for trial outcomes. Transcripts were analyzed using thematic analysis. Outcomes were ranked on the basis of the sum of participants’ priority scores (i.e., single allocation of 3 points for most important, 2 for second, and 1 for third most important outcome). Results: All 26 participants (1 caregiver and 25 patients) preferred an incremental HD approach. The top prioritized outcomes were quality of life (QOL) (56 points), residual kidney function (RKF) (27 points), and mortality (16 points). The following 4 themes underpinning outcome priorities, experience, and safety concerns were identified: (i) unpreparedness and pressure to adapt, (ii) disruption to daily living, (iii) threats to safety, and (iv) hope and future planning. Conclusion: Patients with kidney failure preferred an incremental start to HD to minimize disruption to daily living and reduce the negative impacts on their education, ability to work, and family life. QOL was the most critically important outcome, followed by RKF and survival.
AB - Introduction: Most patients with kidney failure commence and continue hemodialysis (HD) thrice weekly. Incremental initiation (defined as HD less than thrice weekly) is increasingly considered to be safe and less burdensome, but little is known about patients’ perspectives. We aimed to describe patients’ priorities and concerns regarding incremental HD. Methods: Patients currently, previously, or soon to be receiving HD in Australia participated in two 90-minute online workshops to discuss views about HD focusing on incremental start and priorities for trial outcomes. Transcripts were analyzed using thematic analysis. Outcomes were ranked on the basis of the sum of participants’ priority scores (i.e., single allocation of 3 points for most important, 2 for second, and 1 for third most important outcome). Results: All 26 participants (1 caregiver and 25 patients) preferred an incremental HD approach. The top prioritized outcomes were quality of life (QOL) (56 points), residual kidney function (RKF) (27 points), and mortality (16 points). The following 4 themes underpinning outcome priorities, experience, and safety concerns were identified: (i) unpreparedness and pressure to adapt, (ii) disruption to daily living, (iii) threats to safety, and (iv) hope and future planning. Conclusion: Patients with kidney failure preferred an incremental start to HD to minimize disruption to daily living and reduce the negative impacts on their education, ability to work, and family life. QOL was the most critically important outcome, followed by RKF and survival.
KW - hemodialysis
KW - incremental dialysis
KW - patient perspectives
KW - patient-centered care
KW - quality of life
KW - residual kidney function
UR - http://www.scopus.com/inward/record.url?scp=85146279848&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/1092597
U2 - 10.1016/j.ekir.2022.11.012
DO - 10.1016/j.ekir.2022.11.012
M3 - Article
AN - SCOPUS:85146279848
SN - 2468-0249
VL - 8
SP - 478
EP - 488
JO - Kidney International Reports
JF - Kidney International Reports
IS - 3
ER -