2017
DOI: 10.1111/sdi.12651
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Transitional dialysis care units: A new approach to increase home dialysis modality uptake and patient outcomes

Abstract: 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. Likew… Show more

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Cited by 39 publications
(50 citation statements)
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“…The previous comparison in patient outcomes among hemodialysis and peritoneal dialysis patients has revealed either comparable outcomes or better outcomes for peritoneal dialysis [36,37]. In our study, the facilities not offering peritoneal dialysis performed better than those offering peritoneal dialysis.…”
Section: Discussionsupporting
confidence: 55%
“…The previous comparison in patient outcomes among hemodialysis and peritoneal dialysis patients has revealed either comparable outcomes or better outcomes for peritoneal dialysis [36,37]. In our study, the facilities not offering peritoneal dialysis performed better than those offering peritoneal dialysis.…”
Section: Discussionsupporting
confidence: 55%
“…27 The goals of the program are to improve the education deficits, increase home therapy uptake, and reduce hospitalizations in the first 90 days. 27 In an article by Morfín et al, they demonstrate that by focusing on continuity, reliability, empowerment, and wellness, the uptake rate of home therapies can be increased. 27 Patients desire a sense of freedom over their lives and control over their treatment, but they do not want to be a burden to their caregivers and family members.…”
Section: Discussionmentioning
confidence: 99%
“…This could be addressed through a more graduated programme of education whereby patients are provided options for treatment and able to see them first hand, or through patient navigators who can provide reassurance from a patient's perspective to assist with alleviating some of the concerns. 53 Perceptions of increased out-of-pocket costs together with unsuitable housing, often limit the patients' choices of these modalities. 54 To improve access to home dialysis, policy and programme would need to address these financial issues to assist patients to minimise costs.…”
Section: Open Accessmentioning
confidence: 99%