Home hemodialysis and conventional in‐center hemodialysis in <scp>J</scp>apan: A comparison of health‐related quality of life

Watanabe, Yusuke; Ohno, Yoichi; Inoue, Tsutomu; Takane, Hiroshi; Okada, Hirokazu; Suzuki, Hiromichi

doi:10.1111/hdi.12221

Cited by 21 publications

(17 citation statements)

References 25 publications

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“…Home hemodialysis encourages patient responsibility and self‐care. It improves quality of life, as previously reported . No patients would consider the possibility of returning to hospital‐based dialysis.…”

Section: Discussionsupporting

confidence: 58%

Daily Home Hemodialysis Is an Available Option for Renal Replacement Therapy in Spain

et al. 2016

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The objective of the present study was to analyze the characteristics and survival of patients from our hospital who started home hemodialysis. We analyzed all patients receiving home hemodialysis from 1969 to 2015 (51 patients; age 45 ± 23 years; men 77%). We collected characteristics, hospital admission, and mortality. After a median follow-up of 43 (22-76) months, we found 0-1 hospital admissions per year. Sixty-nine percent received a kidney transplant, and the global mortality was 10%. Survival at 5 years was 96%. Mean equivalent renal urea clearance was 15.6 ± 4.2 mL/min, the β-2 microglobulin reduction rate was 67 ± 18%, the number of antihypertension drugs was 0.7 ± 0.3, and the erythropoietin resistance index was 3.7 ± 2.1 IU/kg/week/g/dL. Daily home hemodialysis is a viable option for renal replacement therapy and should be offered alongside other therapies.

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Section: Discussionsupporting

confidence: 58%

Daily Home Hemodialysis Is an Available Option for Renal Replacement Therapy in Spain

et al. 2016

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“…PD outcomes over the first 3 years of dialysis therapy are superior to those of CHD . Home‐based dialysis can allow for more freedom for patients to make their own lifestyle choices, especially as it relates to employment, hobbies, and family time, improving quality of life . Several studies have reported that 90% or more of nephrologists and other dialysis health care providers would select home therapies for themselves if they required dialysis .…”

Section: Current State Of Dialysis Modalities In the United States Anmentioning

confidence: 99%

Transitional dialysis care units: A new approach to increase home dialysis modality uptake and patient outcomes

Morfín

Yang

Wang

et al. 2017

Seminars in Dialysis

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Home hemodialysis (HHD) and peritoneal dialysis (PD) are associated with better clinical outcomes, lower hospitalization rates, and improved quality of life compared with conventional in-center hemodialysis. However, <12% of patients requiring dialysis therapy use HHD or PD in the United States, even though over 90% of nephrologists would choose home-based dialysis modalities for themselves. Inadequate patient education and decision-making support are key barriers to patients choosing home-based therapy. Likewise, there are key challenges for dialysis providers, including development and optimal delivery of education materials, appropriate staffing, and training. The Satellite Healthcare Optimal Transitions (OT) Program was developed to provide education and decision support to patients during the transitional period. OT provides in-depth education in all dialysis modalities at the start of dialysis over a flexible time period (1-4 weeks, adapted for various learning curves) to allow for time to physical stabilization, self-care training, and modality choice based on each patient's individual life motivations, goals, and environments. OT may provide value to patients and providers by providing comprehensive support for dialysis modality selection, resulting in increased patient confidence to execute home dialysis with the potential for improved patient outcomes, and reduced hospitalizations. | CURRENT STATE OF DIALYSIS MODALITIES IN THE UNITED STATES AND THE LOW RATE OF HOME DIALYSIS UPTAKEThere are three main dialysis modality options for patients with chronic kidney disease (CKD): in-center hemodialysis (CHD), home hemodialysis (HHD), and peritoneal dialysis (PD). HHD and PD have been associated with equivalent or better clinical outcomes and lower hospitalization rates compared with CHD.1-6 Several studies show patient benefit from more frequent hemodialysis.

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“…The tradition of self-care extends to the 1,113 UK patients who performed haemodialysis at home in 2014 [ 1 ]. In addition to the better survival [ 8 ] and quality of life [ 9 ] associated with home HD (HHD), increasing HHD from 4.1% in the UK to the 12.9% used in Australia and New Zealand [ 10 ] would lead to estimated annual savings to the UK National Health Service of £16M (an increase of 1400 people treated with HHD at a saving of £12000 per patient per year [ 11 ]).…”

Section: Introductionmentioning

confidence: 99%

Rationale and design for SHAREHD: a quality improvement collaborative to scale up Shared Haemodialysis Care for patients on centre based haemodialysis

et al. 2017

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BackgroundThe study objective is to assess the effectiveness and economic impact of a structured programme to support patient involvement in centre-based haemodialysis and to understand what works for whom in what circumstances and why. It implements a program of Shared Haemodialysis Care (SHC) that aims to improve experience and outcomes for those who are treated with centre-based haemodialysis, and give more patients the confidence to dialyse independently both at centres and at home.Methods/DesignThe 24 month mixed methods cohort evaluation of 600 prevalent centre based HD patients is nested within a 30 month quality improvement program that aims to scale up SHC at 12 dialysis centres across England. SHC describes an intervention where patients who receive centre-based haemodialysis are given the opportunity to learn, engage with and undertake tasks associated with their treatment.Following a 6-month set up period, a phased implementation programme is initiated across 12 dialysis units using a randomised stepped wedge design with 6 centres participating in each of 2 steps, each lasting 6 months. The intervention utilises quality improvement methodologies involving rapid tests of change to determine the most appropriate mechanisms for implementation in the context of a learning collaborative. Running parallel with the stepped wedge intervention is a mixed methods cohort evaluation that employs patient questionnaires and interviews, and will link with routinely collected data at the end of the study period. The primary outcome measure is the number of patients performing at least 5 dialysis-related tasks collected using 3 monthly questionnaires. Secondary outcomes measures include: the number of people choosing to perform home haemodialysis or dialyse independently in-centre by the end of the study period; end-user recommendation; home dialysis establishment delay; staff impact and confidence; hospitalisation; infection and health economics.DiscussionThe results from this study will provide evidence of impact of SHC, barriers to patient and centre level adoption and inform development of future interventions to support its implementation.Trial registrationISRCTN Number: 93999549, (retrospectively registered 1st May 2017); NIHR Research Portfolio: 31566

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Home hemodialysis and conventional in‐center hemodialysis in Japan: A comparison of health‐related quality of life

Cited by 21 publications

References 25 publications

Daily Home Hemodialysis Is an Available Option for Renal Replacement Therapy in Spain

Daily Home Hemodialysis Is an Available Option for Renal Replacement Therapy in Spain

Transitional dialysis care units: A new approach to increase home dialysis modality uptake and patient outcomes

Rationale and design for SHAREHD: a quality improvement collaborative to scale up Shared Haemodialysis Care for patients on centre based haemodialysis

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