Back to the Future: Changes in the Dialysis Delivery Model in the UK

Brady, Mark E.; O’Donoghue, Donal

doi:10.3747/pdi.2010.00102

Cited by 3 publications

(3 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Factors determining choice of modality include availability of options, clinical contraindications and, importantly, patient preference [6]. Although evidence suggests that 50 % of patients would choose PD where possible [7], the use of PD in the UK has been decreasing over the last decade [8, 9]. In 2012 in the UK, approximately 22 % of incident dialysis patients and 14 % of prevalent dialysis patients used PD [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Peritoneal Dialysis and In-Centre Haemodialysis: A Cost-Utility Analysis from a UK Payer Perspective

Treharne¹,

Liu

Arici³

et al. 2014

Appl Health Econ Health Policy

View full text Add to dashboard Cite

BackgroundWith limited healthcare resources available, cost-effective provision of dialysis to patients with end-stage renal disease (ESRD) is important.ObjectivesTo assess the cost-effectiveness of varying levels of peritoneal dialysis (PD) use versus current practice among incident ESRD patients requiring dialysis.MethodsA Markov model was developed to investigate the cost-effectiveness of increasing uptake of PD to 39 and 50 % versus current practice of 22 % PD from a UK National Health Service perspective for the year of 2013–2014. A scenario with 5 % PD was also considered. Sensitivity analyses were performed.ResultsFive- and 10-year discounted total costs and quality-adjusted life years (QALYs) per patient for the current scenario (22 % PD) were £96,307 and 2.104, and £133,339 and 3.301, respectively. Use of PD in 39 % of patients resulted in 5- and 10-year total per-patient cost savings of £3,180 and £4,102 versus current usage alongside total per-patient QALY increases of 0.017 and 0.020. Use of PD in 50 % of patients resulted in 5- and 10-year per-patient cost savings of £5,238 and £6,758 versus current usage alongside per-patient QALY increases of 0.029 and 0.033. Thus, increasing use of PD was associated with marginally better outcomes and lower costs. Cost savings were driven by lower treatment costs and reduced transport requirements for PD versus haemodialysis. Reducing PD use was associated with higher costs and a small reduction in QALYs.ConclusionsThese findings suggest increasing PD use among incident dialysis patients would be cost-effective, associated with reduced costs and potential modest improvements in quality of life.Electronic supplementary materialThe online version of this article (doi:10.1007/s40258-014-0108-7) contains supplementary material, which is available to authorized users.

show abstract

Section: Introductionmentioning

confidence: 99%

Peritoneal Dialysis and In-Centre Haemodialysis: A Cost-Utility Analysis from a UK Payer Perspective

Treharne¹,

Liu

Arici³

et al. 2014

Appl Health Econ Health Policy

View full text Add to dashboard Cite

show abstract

“…Predialysis education programs are recommended best practice for services ( 1 – 3 ). There is little guidance on how best to support patients making informed treatment decisions and, unsurprisingly, programs vary in their content and delivery across providers ( 4 – 6 ). All services provide leaflets to inform patients about their kidney disease and/or local services, but few are designed explicitly to support informed decision making ( 7 ).…”

mentioning

confidence: 99%

Patient Acceptability of the Yorkshire Dialysis Decision AID (YODDA) Booklet: A Prospective Non-Randomized Comparison Study across 6 Predialysis Services

et al. 2016

View full text Add to dashboard Cite

♦ Background:Patients are satisfied with their kidney care but want more support in making dialysis choices. Predialysis leaflets vary across services, with few being sufficient to enable patients' informed decision making. We describe the acceptability of a patient decision aid and feasibility of evaluating its effectiveness within usual predialysis practice.♦ Methods:Prospective non-randomized comparison design, Usual Care or Usual Care Plus Yorkshire Dialysis Decision Aid Booklet (+YoDDA), in 6 referral centers (Yorkshire-Humber, UK) for patients with sustained deterioration of kidney function. Consenting (C) patients completed questionnaires after predialysis consultation (T1), and 6 weeks later (T2). Measures assessed YoDDA's utility to support patients' decisions and integration within usual care.♦ Results:Usual Care (n = 105) and +YoDDA (n = 84) participant characteristics were similar: male (62%), white (94%), age (mean = 62.6; standard deviation [SD] 14.4), kidney disease severity (glomerular filtration rate [eGFR] mean = 14.7; SD 3.7); decisional conflict was < 25; choice-preference for home versus hospital dialysis approximately 50:50. Patients valued receiving YoDDA, reading it on their own (96%), and sharing it with family (72%). The +YoDDA participants had higher scores for understanding kidney disease, reasoning about options, feeling in control, sharing their decision with family. Study engagement varied by center (estimated range 14 – 49%; mean 45%); participants varied in completion of decision quality measures.♦ Conclusions:Receiving YoDDA as part of predialysis education was valued and useful to patients with worsening kidney disease. Integrating YoDDA actively within predialysis programs will meet clinical guidelines and patient need to support dialysis decision making in the context of patients' lifestyle.

show abstract

“…Wu et al reported that the 3-year technical mortality rate of PD patients in China was 36.7% (7). By encouraging self-care with the aim of improving the quality and length of patients' lives (8), effective self-management was also beneficial in reducing dialysis complications (2) and reducing medical costs (9). But self-management of PD patients has many requirements including solution bag replacement, troubleshooting during operation and diet management (10) which require unbiased pre-dialysis counseling, close consideration of patients' preferences and life situation, as well as easy access to health professionals and technical support (11).…”

mentioning

confidence: 99%