Development of a new tool such as an ESKD decision aid requires vision, multidisciplinary input and ongoing implementation resources. This tool is being integrated into ANZ, ESKD education practice and is promoting the philosophy of shared decision making.

BackgroundA multidisciplinary team in Australia and New Zealand utilized a current decision-making theory to develop the ‘My Kidneys, My Choice’ decision aid (MKDA) to support end-stage kidney disease (ESKD) treatment options in decision-making. Assessment of the MKDA was deemed critical to practice integration.MethodsA multisite pre-test, post-test study design was used. Routine ESKD education was supported by the MKDA. Knowledge levels, worries and priorities were assessed pre- and post-education with Likert-scale questions. MKDA usability and treatment option preferences were surveyed post-test. Data were analysed in SPSS.ResultsNinety-seven participants completed the pre-survey and 72 (70%) the post-survey. Mean pre-test knowledge scores ranged from: 0.88 (SD 1.5) for conservative care to 1.32 (SD 1.3) for centre-based dialysis. Post-decision-making knowledge levels increased significantly (P < 0.001). Worry and flexibility scores all increased significantly (P < 0.05) from pre- to post-test; about future pre- 4.15 (SD 1.3), post- 4.61 (SD 0.76); change to lifestyle 4.23 (SD 1.05), 4.59 (SD 0.8); ability to work/do leisure activities 3.67 (SD 1.56) 4.27 (SD 1.17) and desire for flexibility 4.51 (SD 0.86), 4.76 (SD 0.66). MKDA usability scores were high: easy to understand 4.64, (SD 0.77), easy to follow 4.65, (SD 0.66) and supporting decision-making 4.76 (SD 0.61). MKDA section scores ranged from 4.21 (SD 0.75) for writing treatment choices to 4.90 (SD 0.41) for the use of the treatment option comparison grid.ConclusionsPreliminary MKDA assessment revealed high patient acceptance and usability. Patients had equitable knowledge of all treatment options but experienced higher post-worries levels than anticipated.

The delivery of pre-dialysis education is variable, and does not support all options of dialysis for all individuals. State variances indicate that local policy and health professional teams significantly influence the operation of dialysis programs.

232 Document including abstract 38882 Abstract:

SUMMARY Background Longer, more frequent dialysis at home can improve life expectancy for patients with chronic kidney disease. Increased use of home dialysis therapies also benefits the hospital system, allowing for more efficient allocation of clinic resources. However, the Australian and New Zealand Data Registry statistics highlight the low uptake of home haemodialysis and peritoneal dialysis across Australia. Objective In August 2009, the Australia's HOME Network was established as a national initiative to engage and empower healthcare professionals working in the home dialysis specialty. The aim was to develop solutions to advocate for and ultimately increase the use of home therapies. This paper describes the development, achievement and future plan of the Australian HOME Network. Achievements Achievements to date include: a survey of HOME Network members to assess the current state of patient and healthcare professional‐targeted education resources; development of two patient case studies and activities addressing how to overcome the financial burden experienced by patients on home dialysis. Future projects aim to improve patient and healthcare professional education, and advocacy for home dialysis therapies. Conclusion The HOME Network is supporting healthcare professionals working in the home dialysis specialty to develop solutions and tools that will help to facilitate greater utilisation of home dialysis therapies.