Effects of a Pre-Dialysis Patient Education Program on the Relative Frequencies of Dialysis Modalities

Ribitsch, Werner; Haditsch, Bernd; Otto, Ronald; Schilcher, Gernot; Quehenberger, Franz; Roob, Johannes M.; Rosenkranz, Alexander R.

doi:10.3747/pdi.2011.00255

Cited by 49 publications

(44 citation statements)

References 26 publications

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“…Shared decision-making is a fundamental patient right and requires both balanced information and an iterative mechanism for a consensual decision based on shared understanding and values. [109][110][111] It is known that well-implemented predialysis education and/or shared decision-making results in patients prospectively choosing PD *50% of the time, [112][113][114][115][116][117][118] which is similar to the reported preference of health-care professionals when they are presented with the hypothetical case of their own ESKD. 119,120 There is an opportunity to improve patient satisfaction with the dialysis treatment through better shared decisions, [121][122][123][124][125][126][127][128][129][130] with choices that better meet patient needs.…”

Section: Discussionmentioning

confidence: 72%

The benefit of early survival on PD versus HD—Why this is (still) very important

Marshall

2020

Perit Dial Int

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There are a number of misconceptions around the identified early survival benefit of peritoneal dialysis (PD) relative to hemodialysis (HD), including that such benefits "even out in the end" since the relative risk of death over time eventually encompasses 1.0 (or even an estimate that is unfavorable to PD); that the early benefit is, in fact, most likely due to unmeasured confounding; and such benefits are only due to the influence of central venous catheters and "crash starters" in the HD group. In fact, the early survival benefit results in a substantial gain of patient life years in PD cohorts relative to HD ones, even if it the benefit appears to "even out in the end," is relatively insensitive to unmeasured confounding, and persists even when the effects of central venous catheters are accounted for. In this review, the calculations and arguments are made to support these tenets. Survival on dialysis is still one of the most important considerations for all stakeholders in the end-stage kidney disease community, including patients who rank it among their top priorities. Shared decision-making is a fundamental patient right and requires both balanced information and an iterative mechanism for a consensual decision based on shared understanding and purpose. A cornerstone of this process should be an explicit discussion of the early survival benefit of PD relative to HD.Why early, beneficial hazard ratios do not "even out in the end" if the hazard ratio subsequently encompasses 1.0In medical research, comparing the relative risk of death between two treatments involves the calculation of a ratio: a rate ratio, an odds ratio, or a hazard ratio (HR) depending on the type of statistical test used for the computation. A Poisson model compares the frequency (rate ratio), a

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Section: Discussionmentioning

confidence: 72%

The benefit of early survival on PD versus HD—Why this is (still) very important

Marshall

2020

Perit Dial Int

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“…Nonsteroidal anti-inflammatory drug (NSAID) avoidance education in patients at risk for AKI increased knowledge of NSAID-associated risks and patient-reported intentions to limit NSAID use (5). CKD patient education programs may defer dialysis initiation (6), increase use of self-care-based dialysis modalities (7,8), lengthen survival on dialysis (9)(10)(11), and improve overall mood and feelings of good health (12). National programs and CKD care guidelines uniformly recommend patient education as a critical component of care (13)(14)(15)(16).…”

Section: Benefits Of Patient Educationmentioning

confidence: 99%

Educating Patients about CKD

Narva

Norton

Boulware

2016

Clinical Journal of the American Society of Nephrology

205

190

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Patient education is associated with better patient outcomes and supported by international guidelines and organizations, but a range of barriers prevent widespread implementation of comprehensive education for people with progressive kidney disease, especially in the United States. Among United States patients, obstacles to education include the complex nature of kidney disease information, low baseline awareness, limited health literacy and numeracy, limited availability of CKD information, and lack of readiness to learn. For providers, lack of time and clinical confidence combine with competing education priorities and confusion about diagnosing CKD to limit educational efforts. At the system level, lack of provider incentives, limited availability of practical decision support tools, and lack of established interdisciplinary care models inhibit patient education. Despite these barriers, innovative education approaches for people with CKD exist, including self-management support, shared decision making, use of digital media, and engaging families and communities. Education efficiency may be increased by focusing on people with progressive disease, establishing interdisciplinary care management including community health workers, and providing education in group settings. New educational approaches are being developed through research and quality improvement efforts, but challenges to evaluating public awareness and patient education programs inhibit identification of successful strategies for broader implementation. However, growing interest in improving patient-centered outcomes may provide new approaches to effective education of people with CKD.

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“…Research shows that patient choice of dialysis modality is driven by a myriad of clinical factors (e.g., suitability for self-care, vascular or abdominal heath) and nonclinical factors (e.g., physician and patient preference, patients' employment status, social support at home) (Ahlmen, Carlsson, and Schonborg 1993;Stack 2002;Hirth et al 2003;McLaughlin et al 2003;Golper et al 2011;Maaroufi et al 2013). Patients' education, awareness, and understanding of these dialysis modalities have also been shown to influence modality choice (McLaughlin et al 2003;Golper et al 2011;Kutner et al 2011;Blake, Quinn, and Oliver 2013;Ribitsch et al 2013;Kurella Tamura et al 2014). The availability of treatment services in local facilities may play a role in patients' awareness of and exposure to different modalities, but it has received less attention.…”

mentioning

confidence: 99%

Impacts of Geographic Distance on Peritoneal Dialysis Utilization: Refining Models of Treatment Selection

Wang

Maciejewski

Sanders

et al. 2016

Health Services Research

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Effects of a Pre-Dialysis Patient Education Program on the Relative Frequencies of Dialysis Modalities

Cited by 49 publications

References 26 publications

The benefit of early survival on PD versus HD—Why this is (still) very important

The benefit of early survival on PD versus HD—Why this is (still) very important

Educating Patients about CKD

Impacts of Geographic Distance on Peritoneal Dialysis Utilization: Refining Models of Treatment Selection

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