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Appropriateness of the dialysis modality selection process: A cross-sectional study

Studies that specifically quantify the appropriateness of the process of dialysis modality selection are lacking. Peritoneal dialysis (PD) offers clinical and social advantages over hemodialysis (HD), but may be underused. We aimed to determine the appropriateness of the process of dialysis modality...

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Autores principales: Salas-Gama, Karla, Díaz-Gómez, Juan-Manuel, Bolíbar Ribas, Ignasi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9592345/
https://www.ncbi.nlm.nih.gov/pubmed/36281100
http://dx.doi.org/10.1097/MD.0000000000031041
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author Salas-Gama, Karla
Díaz-Gómez, Juan-Manuel
Bolíbar Ribas, Ignasi
author_facet Salas-Gama, Karla
Díaz-Gómez, Juan-Manuel
Bolíbar Ribas, Ignasi
author_sort Salas-Gama, Karla
collection PubMed
description Studies that specifically quantify the appropriateness of the process of dialysis modality selection are lacking. Peritoneal dialysis (PD) offers clinical and social advantages over hemodialysis (HD), but may be underused. We aimed to determine the appropriateness of the process of dialysis modality selection and quantify the percentage of patients who could potentially have been PD candidates. We performed a cross-sectional study that included adult patients from a hospital Nephrology Department in Barcelona who started dialysis between 2014 and 2015. We assessed the appropriateness of dialysis modalities selection by defining 3 sequential domains based on 3 critical steps in choosing a dialysis modality: eligibility for either treatment, information about modalities, and shared decision-making. We obtained data using medical records and a patient questionnaire. The dialysis modality selection process was considered appropriate when patients had no contraindications for the selected option, received complete information about both modalities, and voluntarily chose the selected option. A total of 141 patients were included in this study. The median age was 72 years (interquartile range 63–82 years), and 65% of the patients were men. The dialysis modality selection process was potentially inappropriate in 22% of the participants because of problems related to information about dialysis modalities (15%) or shared decision-making (7%). Appropriate PD use can potentially increase from 17% to 38%. Patient age and lack of information regarding dialysis options were independently associated with the potential degree of inappropriate dialysis modality selection. Our findings indicate areas for improvement in the selection of dialysis modalities. With better education and shared decision-making, the number of patients with PD could potentially double. The analysis of appropriateness is a helpful approach for studying renal replacement treatment patterns and identifying strategies to optimize their use.
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spelling pubmed-95923452022-10-25 Appropriateness of the dialysis modality selection process: A cross-sectional study Salas-Gama, Karla Díaz-Gómez, Juan-Manuel Bolíbar Ribas, Ignasi Medicine (Baltimore) 5200 Studies that specifically quantify the appropriateness of the process of dialysis modality selection are lacking. Peritoneal dialysis (PD) offers clinical and social advantages over hemodialysis (HD), but may be underused. We aimed to determine the appropriateness of the process of dialysis modality selection and quantify the percentage of patients who could potentially have been PD candidates. We performed a cross-sectional study that included adult patients from a hospital Nephrology Department in Barcelona who started dialysis between 2014 and 2015. We assessed the appropriateness of dialysis modalities selection by defining 3 sequential domains based on 3 critical steps in choosing a dialysis modality: eligibility for either treatment, information about modalities, and shared decision-making. We obtained data using medical records and a patient questionnaire. The dialysis modality selection process was considered appropriate when patients had no contraindications for the selected option, received complete information about both modalities, and voluntarily chose the selected option. A total of 141 patients were included in this study. The median age was 72 years (interquartile range 63–82 years), and 65% of the patients were men. The dialysis modality selection process was potentially inappropriate in 22% of the participants because of problems related to information about dialysis modalities (15%) or shared decision-making (7%). Appropriate PD use can potentially increase from 17% to 38%. Patient age and lack of information regarding dialysis options were independently associated with the potential degree of inappropriate dialysis modality selection. Our findings indicate areas for improvement in the selection of dialysis modalities. With better education and shared decision-making, the number of patients with PD could potentially double. The analysis of appropriateness is a helpful approach for studying renal replacement treatment patterns and identifying strategies to optimize their use. Lippincott Williams & Wilkins 2022-10-21 /pmc/articles/PMC9592345/ /pubmed/36281100 http://dx.doi.org/10.1097/MD.0000000000031041 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.
spellingShingle 5200
Salas-Gama, Karla
Díaz-Gómez, Juan-Manuel
Bolíbar Ribas, Ignasi
Appropriateness of the dialysis modality selection process: A cross-sectional study
title Appropriateness of the dialysis modality selection process: A cross-sectional study
title_full Appropriateness of the dialysis modality selection process: A cross-sectional study
title_fullStr Appropriateness of the dialysis modality selection process: A cross-sectional study
title_full_unstemmed Appropriateness of the dialysis modality selection process: A cross-sectional study
title_short Appropriateness of the dialysis modality selection process: A cross-sectional study
title_sort appropriateness of the dialysis modality selection process: a cross-sectional study
topic 5200
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9592345/
https://www.ncbi.nlm.nih.gov/pubmed/36281100
http://dx.doi.org/10.1097/MD.0000000000031041
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