Influence of a Pre-Dialysis Education Programme (PDEP) on the mode of renal replacement therapy

Abstract

In our centre offering all treatment RRT modalities, a high percentage of patients exposed to a structured PDEP start with a self-care RRT modality. This leaves in-centre HD for patients needing medical and nursing care, or for patients refusing to participate in their treatment. Additional large studies, preferably with a randomized design, should delineate the cost-benefit of such a PDEP on the final choice of a RRT modality.

Peritoneal Dialysis and the Process of Modality Selection

“…Of patients assessed, the proportion that are declared eligible for PD will vary widely (7,8,(12)(13)(14). Key factors will include the age and overall comorbidity burden of the population being accepted for dialysis.…”

“…The element of experience and confidence may also be such that, compared with newer PD programs, more established PD programs might be more "aggressive" about offering PD to "marginal" patients. When centers are compared, the estimated proportion of patients eligible to do PD is highly variable, typically running between 40% and 80%-thus being a major determinant of a program's ultimate PD utilization percentage (7,8,(12)(13)(14). The whole topic of perceived eligibility and ineligibility to do PD is an area that needs extensive research, and we think that application of the process we are suggesting would be helpful in highlighting inappropriate differences between PD programs.…”

Invited Manuscript Poster on Renal-Related Education American Society of Nephrology, Nov. 16–21, 2010 Improving Access to Kidney Transplant Information has Increased Preemptive Living Kidney Donation

“…9 The aim of such a program is to decrease the mystique surrounding treatment, provide patients with objective information about ESRD treatment options, help them make suitable choices, and promote self-care. One study looking at renal replacement therapy choice with a predialysis education program however resulted in only 8 out of 235 having a preemptive transplant 9 indicating that additional factors are required to increase preemptive transplantation. Where it is a common belief among renal professionals that self-care therapies are under-used, preemptive transplantation is similarly underutilized.…”

Intérêt des interventions psychologiques en dialyse : étude exploratoire

“…Les é tudes du premier type soulignent une amé lioration de l'adhé sion thé rapeutique des patients dialysé s [16][17][18][19] ; la possibilité de retarder au maximum l'entré e en dialyse ainsi qu'un meilleur ajustement entre type de dialyse et patient [20][21][22] ; une amé lioration de l'autonomie des patients permettant, à terme, de les rediriger vers une antenne d'autodialyse [23] et enfin une amé lioration de leur é tat de santé et de leur qualité de vie globale grâce à un programme de ré entraînement sportif [24].…”