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Perceptions about the dialysis modality decision process among peritoneal dialysis and in-center hemodialysis patients

BACKGROUND: Patients reaching end-stage renal disease must make a difficult decision regarding renal replacement therapy (RRT) options. Because the choice between dialysis modalities should include patient preferences, it is critical that patients are engaged in the dialysis modality decision. As pa...

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Autores principales: Zee, Jarcy, Zhao, Junhui, Subramanian, Lalita, Perry, Erica, Bryant, Nicole, McCall, Margie, Restovic, Yanko, Torres, Delma, Robinson, Bruce M., Pisoni, Ronald L., Tentori, Francesca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206892/
https://www.ncbi.nlm.nih.gov/pubmed/30373558
http://dx.doi.org/10.1186/s12882-018-1096-x
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author Zee, Jarcy
Zhao, Junhui
Subramanian, Lalita
Perry, Erica
Bryant, Nicole
McCall, Margie
Restovic, Yanko
Torres, Delma
Robinson, Bruce M.
Pisoni, Ronald L.
Tentori, Francesca
author_facet Zee, Jarcy
Zhao, Junhui
Subramanian, Lalita
Perry, Erica
Bryant, Nicole
McCall, Margie
Restovic, Yanko
Torres, Delma
Robinson, Bruce M.
Pisoni, Ronald L.
Tentori, Francesca
author_sort Zee, Jarcy
collection PubMed
description BACKGROUND: Patients reaching end-stage renal disease must make a difficult decision regarding renal replacement therapy (RRT) options. Because the choice between dialysis modalities should include patient preferences, it is critical that patients are engaged in the dialysis modality decision. As part of the Empowering Patients on Choices for RRT (EPOCH-RRT) study, we assessed dialysis patients’ perceptions of their dialysis modality decision-making process and the impact of their chosen modality on their lives. METHODS: A 39-question survey was developed in collaboration with a multi-stakeholder advisory panel to assess perceptions of patients on either peritoneal dialysis (PD) or in-center hemodialysis (HD). The survey was disseminated to participants in the large US cohorts of the Dialysis Outcomes and Practice Patterns Study (DOPPS) and the Peritoneal DOPPS (PDOPPS). Survey responses were compared between PD and in-center HD patients using descriptive statistics, adjusted logistic generalized estimating equation models, and linear mixed regression models. RESULTS: Six hundred fourteen PD and 1346 in-center HD participants responded. Compared with in-center HD participants, PD participants more frequently reported that they were engaged in the decision-making process, were provided enough information, understood differences between dialysis modalities, and felt satisfied with their modality choice. PD participants also reported more frequently than in-center HD participants that partners or spouses (79% vs. 70%), physician assistants (80% vs. 66%), and nursing staff (78% vs. 60%) had at least some involvement in the dialysis modality decision. Over 35% of PD and in-center HD participants did not know another dialysis patient at the time of their modality decision and over 60% did not know the disadvantages of their modality type. Participants using either dialysis modality perceived a moderate to high impact of dialysis on their lives. CONCLUSIONS: PD participants were more engaged in the modality decision process compared to in-center HD participants. For both modalities, there is room for improvement in patient education and other support for patients choosing a dialysis modality. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12882-018-1096-x) contains supplementary material, which is available to authorized users.
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spelling pubmed-62068922018-10-31 Perceptions about the dialysis modality decision process among peritoneal dialysis and in-center hemodialysis patients Zee, Jarcy Zhao, Junhui Subramanian, Lalita Perry, Erica Bryant, Nicole McCall, Margie Restovic, Yanko Torres, Delma Robinson, Bruce M. Pisoni, Ronald L. Tentori, Francesca BMC Nephrol Research Article BACKGROUND: Patients reaching end-stage renal disease must make a difficult decision regarding renal replacement therapy (RRT) options. Because the choice between dialysis modalities should include patient preferences, it is critical that patients are engaged in the dialysis modality decision. As part of the Empowering Patients on Choices for RRT (EPOCH-RRT) study, we assessed dialysis patients’ perceptions of their dialysis modality decision-making process and the impact of their chosen modality on their lives. METHODS: A 39-question survey was developed in collaboration with a multi-stakeholder advisory panel to assess perceptions of patients on either peritoneal dialysis (PD) or in-center hemodialysis (HD). The survey was disseminated to participants in the large US cohorts of the Dialysis Outcomes and Practice Patterns Study (DOPPS) and the Peritoneal DOPPS (PDOPPS). Survey responses were compared between PD and in-center HD patients using descriptive statistics, adjusted logistic generalized estimating equation models, and linear mixed regression models. RESULTS: Six hundred fourteen PD and 1346 in-center HD participants responded. Compared with in-center HD participants, PD participants more frequently reported that they were engaged in the decision-making process, were provided enough information, understood differences between dialysis modalities, and felt satisfied with their modality choice. PD participants also reported more frequently than in-center HD participants that partners or spouses (79% vs. 70%), physician assistants (80% vs. 66%), and nursing staff (78% vs. 60%) had at least some involvement in the dialysis modality decision. Over 35% of PD and in-center HD participants did not know another dialysis patient at the time of their modality decision and over 60% did not know the disadvantages of their modality type. Participants using either dialysis modality perceived a moderate to high impact of dialysis on their lives. CONCLUSIONS: PD participants were more engaged in the modality decision process compared to in-center HD participants. For both modalities, there is room for improvement in patient education and other support for patients choosing a dialysis modality. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12882-018-1096-x) contains supplementary material, which is available to authorized users. BioMed Central 2018-10-29 /pmc/articles/PMC6206892/ /pubmed/30373558 http://dx.doi.org/10.1186/s12882-018-1096-x Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Zee, Jarcy
Zhao, Junhui
Subramanian, Lalita
Perry, Erica
Bryant, Nicole
McCall, Margie
Restovic, Yanko
Torres, Delma
Robinson, Bruce M.
Pisoni, Ronald L.
Tentori, Francesca
Perceptions about the dialysis modality decision process among peritoneal dialysis and in-center hemodialysis patients
title Perceptions about the dialysis modality decision process among peritoneal dialysis and in-center hemodialysis patients
title_full Perceptions about the dialysis modality decision process among peritoneal dialysis and in-center hemodialysis patients
title_fullStr Perceptions about the dialysis modality decision process among peritoneal dialysis and in-center hemodialysis patients
title_full_unstemmed Perceptions about the dialysis modality decision process among peritoneal dialysis and in-center hemodialysis patients
title_short Perceptions about the dialysis modality decision process among peritoneal dialysis and in-center hemodialysis patients
title_sort perceptions about the dialysis modality decision process among peritoneal dialysis and in-center hemodialysis patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206892/
https://www.ncbi.nlm.nih.gov/pubmed/30373558
http://dx.doi.org/10.1186/s12882-018-1096-x
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