Multidimensional analysis of factors responsible for the low prevalence of ambulatory peritoneal dialysis in Germany (MAU-PD): a cross-sectional Mixed-Methods Study Protocol

Abstract

IntroductionPatients with end-stage kidney failure can be treated either by transplant or by dialysis, which can be administered as haemodialysis (HD) or peritoneal dialysis (PD). Although they are equivalent therapeutic options in terms of mortality, the percentage of patients in Germany treated with PD is currently very low (∼6%) compared with other countries. The aim of our study is to analyse the factors behind this percentage and their relevance to the choice of dialysis treatment in Germany. This includes analyses of regional disparities in the provision of care for dialysis patients as well as the evaluations of costs and the influence of reimbursement structures. This approach should provide further insights to explain the variation in the usage of PD and HD and will help to define starting points for future interventions.Methods and analysisA mixed-methods approach will be applied to several data sources, including administrative data (ambulatory physicians’ claim data, statutory health insurance claim data), quality assurance data from one of the largest German dialysis providers Kuratorium für Dialyse (KfH) and qualitative and quantitative survey data (patients, nephrologists and dialysis nurses). Qualitative data will be analysed content-analytically. Based on the quantitative data, multivariable analyses will be performed and, where possible, hierarchical models will be tested. This multidimensional approach will enable us to account for the different factors influencing the penetration of PD in Germany.Ethics and disseminationEthics approval (17-299) has been obtained from the Ethics Committee of the Medical Faculty of the University of Cologne on 25 April 2018. National and international dissemination will be accomplished by informing healthcare practitioners, patients and professional organisations and other stakeholders via conferences, scientific and non-scientific publications and seminars.Trial registration numberDRKS00012555; Pre-Results.

Early Referral to Nephrological Care and the Uptake of Peritoneal Dialysis. An Analysis of German Claims Data

“…The database for this study consists of all medical encounters of 34,200 patients with ESRD from 2012 to 2016, i.e., those who had at least one documentation of International Classification of Diseases (ICD) code N18.5 between 2012 and 2016. The investigation was part of the MAU-PD study (Multidimensional analysis of causes for the low prevalence of ambulatory peritoneal dialysis in Germany) [32]. The study was funded by the Federal Joint Committee's innovation fund (Funding No 01VSF16036).…”

The role of personal attitudes of control and responsibility for the uptake of peritoneal dialysis- a national survey among dialysis patients

“…After a one-time reminder, regardless of whether the survey had been completed by that time or not, 964 participants responded (46% response rate). The survey was carried out as part of the MAU-PD study (German Clinical Trials Register ID: DRKS00012555), which aims to assess the reasons for the low PD ratio in Germany from different perspectives with a mixed-methods design [ 33 ].…”

Assistierte Dialyse: Was entwickelt sich in Deutschland und darüber hinaus?

“…Das MAU-PD-Projekt erhielt eine Förderung durch den Gemeinsamen Bundesausschuss (G-BA) im Rahmen des Innovationsfonds. Die Ergebnisse wurden vom G-BA 2020 offiziell an die folgenden Stellen mit entsprechenden Aufträgen übermittelt [23] Auch für die Versorgung der Gruppe der herzinsuffizienten Patienten ist die Peritonealdialyse, und wenn erforderlich die asPD, eine sehr gute Behandlungsoption [28]. In Dänemark wird asPD in allen Dialyseeinrichtungen angeboten.…”