Is home hemodialysis a practical option for older people?

Wu, Henry H. L.; Nixon, Andrew; Dhaygude, Ajay; Jayanti, Anu; Mitra, Sandip

doi:10.1111/hdi.12949

Cited by 3 publications

(3 citation statements)

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“…The prevalence of caregiver overburden when taking care of an older adult receiving dialysis is variable across published observational studies, with this being reported as high as 85% [ 92 , 93 ]. Family members of older patients receiving home dialysis may require full-time employment for financial sustainability, and taking up caregiver roles and responsibilities simultaneously may lead to caregiver burnout [ 94 ]. Caregivers for older patients receiving home dialysis may also be older individuals themselves with chronic illness, and this responsibility could add further physical and psychological burden [ 94 ].…”

Section: Supporting Older Adults Who Are Receiving Home Dialysismentioning

confidence: 99%

“…Family members of older patients receiving home dialysis may require full-time employment for financial sustainability, and taking up caregiver roles and responsibilities simultaneously may lead to caregiver burnout [ 94 ]. Caregivers for older patients receiving home dialysis may also be older individuals themselves with chronic illness, and this responsibility could add further physical and psychological burden [ 94 ]. Qualitative studies reported low mood in a significant proportion of family members caring for patients on nocturnal PD and HHD [ 88–91 ].…”

Section: Supporting Older Adults Who Are Receiving Home Dialysismentioning

confidence: 99%

“…On the contrary, the presence of significant frailty may negatively affect incident uptake and dropout on home dialysis [ 99 ]. Focusing on measured frailty rather than age alone may help address some of the challenges and emerging solutions in this population [ 94 , 97 , 100 , 101 ]. Access to dedicated pre-habilitation programs, nutrition support and rehabilitation programs delivered either face-to-face or remotely via digital interface may help prevent deterioration and drop outs and also positively impact on health outcomes and well-being on home therapies [ 100 ].…”

Section: Supporting Older Adults Who Are Receiving Home Dialysismentioning

confidence: 99%

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Home dialysis in older adults: challenges and solutions

Dhaygude

Mitra

et al. 2022

Clinical Kidney Journal

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There is a rising demand for dialysis in the older population given the increased numbers of older adults living with chronic kidney disease (CKD) progressing to kidney failure. Home dialysis i.e. peritoneal dialysis (PD) and home hemodialysis (HHD) has been available for decades, but more recently, there has been a rapid increase in home dialysis utilization as patients and clinicians consider its practical and clinical advantages. For older adults, incident home dialysis utilization more than doubled and prevalent home dialysis growth nearly doubled over the past decade. Whilst its advantages and recent rise in popularity are evident, there are numerous barriers and challenges that are important to consider prior to initiating older adults on home dialysis. Some nephrology healthcare professionals do not view home dialysis as an option for older adults. Successful delivery of home dialysis for older adults may be made even more difficult by physical or cognitive limitations, concerns around dialysis adequacy, treatment-related complications, as well as challenges relating to caregiver burnout and patient frailty that are unique to home dialysis and older adults. Ultimately, it would be important for clinicians, patients and their caregivers to define what constitutes a ‘successful therapy’ to ensure treatment goals are aligned towards each individual's priorities of care, considering the complex challenges that surrounds an older adult receiving home dialysis. In this review, we evaluate some of the key challenges surrounding the delivery of home dialysis to older adults and propose potential solutions based on updated evidence to overcome these challenges.

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Section: Supporting Older Adults Who Are Receiving Home Dialysismentioning

confidence: 99%

Section: Supporting Older Adults Who Are Receiving Home Dialysismentioning

confidence: 99%

Section: Supporting Older Adults Who Are Receiving Home Dialysismentioning

confidence: 99%

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Home dialysis in older adults: challenges and solutions

Dhaygude

Mitra

et al. 2022

Clinical Kidney Journal

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Participation in eHealth Communication Interventions Among Patients Undergoing Hemodialysis: Scoping Review

Deinboll,

Moe,

Ludvigsen

2024

J Med Internet Res

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Background eHealth communication interventions have been shown to offer individuals with chronic kidney disease the opportunity to embrace dialysis therapies with greater confidence, the potential to obtain better clinical outcomes, and an increased quality of life. eHealth is an emerging field that offers diverse, flexible designs and delivery options. However, existing evidence on eHealth communication among patients undergoing hemodialysis is sparse and scattered and lacks systematization. Objective This scoping review aims to identify and map the current evidence on patient participation in eHealth communication interventions. We aimed to map the associations between interventions and electronic health records, the participative role of individuals living with chronic kidney disease and undergoing hemodialysis, and the barriers to and facilitators of patient involvement in eHealth communication with health care professionals. Methods This study used the Joanna Briggs Institute methodology for conducting a scoping review. Studies eligible for inclusion were those that included adult patients (aged >18 y) undergoing all types of hemodialysis, including prescheduled in-center hemodialysis and conventional home-based hemodialysis. Systematic searches were completed in Ovid MEDLINE, Ovid Embase, EBSCOhost CINAHL with Full Text, Scopus, and ProQuest Dissertations and Theses. Extracted data from the included studies were presented in figures and tables along with descriptions that responded to the research questions. This review was reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Results In total, 9 peer-reviewed studies were included. The main result was a low participative patient role and a vaguely described link to electronic health records. The key participative facilitators were availability of and access to the intervention; security, trust, and confidence; patient knowledge of their health situation and use of self-care; and patient preparedness for an uncertain future health situation and the ability to relate to family and friends about it. The key participative barriers were lack of availability of and access to information, mistrust and lack of safety, lack of knowledge of health situation and self-care, and relational issues. All barriers and facilitators were related to health literacy. Conclusions This scoping review summarizes 4 specific and 3 nonspecific eHealth communication interventions developed and evaluated in various studies involving patients receiving hemodialysis. A knowledge gap exists between low levels of patient participation in eHealth communication and patients’ limited access to electronic health records. eHealth communication interventions should implement patient participation and focus on the fact that different modalities of eHealth communication can complement face-to-face communication. International Registered Report Identifier (IRRID) RR2-10.2196/38615

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Participation in eHealth Communication Interventions Among Patients Undergoing Hemodialysis: Scoping Review (Preprint)

Deinboll,

Moe,

Ludvigsen

2023

Preprint

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BACKGROUND eHealth communication interventions have been shown to offer individuals with chronic kidney disease the opportunity to embrace dialysis therapies with greater confidence, the potential to obtain better clinical outcomes, and an increased quality of life. eHealth is an emerging field that offers diverse, flexible designs and delivery options. However, existing evidence on eHealth communication among patients undergoing hemodialysis is sparse and scattered and lacks systematization. OBJECTIVE This scoping review aims to identify and map the current evidence on patient participation in eHealth communication interventions. We aimed to map the associations between interventions and electronic health records, the participative role of individuals living with chronic kidney disease and undergoing hemodialysis, and the barriers to and facilitators of patient involvement in eHealth communication with health care professionals. METHODS This study used the Joanna Briggs Institute methodology for conducting a scoping review. Studies eligible for inclusion were those that included adult patients (aged >18 y) undergoing all types of hemodialysis, including prescheduled in-center hemodialysis and conventional home-based hemodialysis. Systematic searches were completed in Ovid MEDLINE, Ovid Embase, EBSCOhost CINAHL with Full Text, Scopus, and ProQuest Dissertations and Theses. Extracted data from the included studies were presented in figures and tables along with descriptions that responded to the research questions. This review was reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. RESULTS In total, 9 peer-reviewed studies were included. The main result was a low participative patient role and a vaguely described link to electronic health records. The key participative facilitators were availability of and access to the intervention; security, trust, and confidence; patient knowledge of their health situation and use of self-care; and patient preparedness for an uncertain future health situation and the ability to relate to family and friends about it. The key participative barriers were lack of availability of and access to information, mistrust and lack of safety, lack of knowledge of health situation and self-care, and relational issues. All barriers and facilitators were related to health literacy. CONCLUSIONS This scoping review summarizes 4 specific and 3 nonspecific eHealth communication interventions developed and evaluated in various studies involving patients receiving hemodialysis. A knowledge gap exists between low levels of patient participation in eHealth communication and patients’ limited access to electronic health records. eHealth communication interventions should implement patient participation and focus on the fact that different modalities of eHealth communication can complement face-to-face communication. INTERNATIONAL REGISTERED REPORT RR2-10.2196/38615

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Is home hemodialysis a practical option for older people?

Cited by 3 publications

References 65 publications

Home dialysis in older adults: challenges and solutions

Home dialysis in older adults: challenges and solutions

Participation in eHealth Communication Interventions Among Patients Undergoing Hemodialysis: Scoping Review

Participation in eHealth Communication Interventions Among Patients Undergoing Hemodialysis: Scoping Review (Preprint)

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