Estimating Preference Scores in Conventional and Home Nocturnal Hemodialysis Patients

McFarlane, Philip A.; Pierratos, Andreas; Bayoumi, Ahmed M.; Redelmeier, Donald A.

doi:10.2215/cjn.03941106

Cited by 12 publications

(8 citation statements)

References 45 publications

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“…20,21 Improved quality of life Findings from many observational cohort studies suggest that patients' QOL is better on IHHD than on incentre CHD. [22][23][24][25][26] Furthermore, in a systematic review of 197 patients from 13 HHD programs, a consistent improve ment in QOL was demonstrated for patients receiving IHHD versus those receiving incentre CHD, although the included studies were not of consistently high quality. 27 QOL for patients receiving home NHD has also been evaluated in two RCTs.…”

Section: Improved Survivalmentioning

confidence: 99%

Intensive home haemodialysis: benefits and barriers

2012

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Accumulating evidence of the benefits of intensive home haemodialysis has led to increased international interest in this modality as a viable option for renal replacement therapy. Until the late 1970s, haemodialysis was primarily performed at home; however, the development of in-centre and satellite dialysis units and the advent of peritoneal dialysis led to decreased numbers of patients being managed by home haemodialysis. Over the past decade, a move towards once again providing and supporting haemodialysis at home has emerged, due to a desire to offer a more convenient form of dialysis for the patient in a more cost-effective manner. This shift has generated clinical evidence indicating benefits both from receiving haemodialysis at home, and from the option to provide intensive dialysis treatment in this setting. With the development of new home haemodialysis programs, specific patient-related, physician-related and cost-related barriers to their introduction have been encountered, including patient fear of self-cannulation and lack of expert medical knowledge in the area. This Review discusses the benefits and barriers associated with intensive home haemodialysis.

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Section: Improved Survivalmentioning

confidence: 99%

Intensive home haemodialysis: benefits and barriers

2012

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“…The quality of life of patients receiving dialysis is amongst the worst reported for any chronic medical condition (8). Utility scores rank quality of life on a scale from 0 (the worst imaginable quality of life, often equated to death) and 1 (the best imaginable quality of life) (9,10). Utility scores on conventional HD are typically in the range of about 0.5, while utility scores in people with a working kidney transplant tend to be significantly higher in the 0.7 range (8,11,12).…”

Section: Quality Of Lifementioning

confidence: 99%

Should Patients Remain on Intensive Hemodialysis Rather than Choosing to Receive a Kidney Transplant?

McFarlane

2010

Seminars in Dialysis

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Most dialysis patients would choose to receive a kidney transplant if possible. However, some patients who are receiving intensive hemodialysis (HD) have opted against transplantation and have chosen to remain on dialysis. In this paper, we examine studies that help to inform the decision between receiving a kidney transplant and remaining on intensive HD. There are no randomized trials directly comparing transplant to intensive HD. Database and prospective nonrandomized studies support a number of conclusions. First, compared to conventional HD, survival appears to be better with either transplantation or intensive HD. Survival appears to be similar between intensive HD and deceased donor kidney transplantation, but the best survival is reported with live donor transplantation. Secondly, people with a kidney transplant or receiving intensive HD report a higher quality of life than people on conventional HD. There is insufficient evidence to determine whether there are significant quality of life differences between these treatments. Finally, the costs of intensive HD compare favorably to those of conventional HD. Renal transplantation is more costly in the first year, but after about 2 years should be less costly than any form of HD. Based on these studies eligible intensive HD patients should be encouraged to pursue transplantation, especially live kidney donor transplantation. Individual concerns about the relative risks and benefits of renal transplantation may drive some patients to choose to stay on dialysis. Clinicians should explore the reasons behind such a decision to ensure that the patient is properly informed; however, appropriately reasoned decisions should be respected.

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“… 5 , 6 , 7 , 8 For patients who are unable to or are waiting to receive a kidney transplant, extended hours of home hemodialysis is associated with clinical and quality-of-life outcomes that are closer to transplantation than other dialysis modalities. 9 , 10 , 11 , 12 , 13 , 14 …”

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confidence: 99%

Patients’ Experiences of Community House Hemodialysis: A Qualitative Study

et al. 2019

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Rationale & Objective Community house hemodialysis is a submodality of home hemodialysis that enables patients to perform hemodialysis independent of nursing or medical supervision in a shared house. This study describes the perspectives and experiences of patients using community house hemodialysis in New Zealand to explore ways this dialysis modality may support the wider delivery of independent hemodialysis care. Study Design Qualitative semi-structured in-depth interview study. Setting & Participants 25 patients who had experienced community house hemodialysis. Participants were asked about why they chose community house hemodialysis and their experiences and perspectives of this. Analytical Approach Thematic analysis using an inductive approach. Results 25 patients were interviewed (14 men and 11 women, aged 31-65 years). Most were of Māori or Pacific ethnicity and in part- or full-time employment. More than two-thirds dialyzed for 20 hours a week or more. We identified 4 themes that described patients’ experiences and perspectives of choosing and using community house hemodialysis: reducing burden on family (when home is not an option, minimizing family exposure to dialysis, maintaining privacy and self-identity, reducing the costs of home hemodialysis, and gaining a reprieve from home), offering flexibility and freedom (having a normal life, maintaining employment, and facilitating travel), control of my health (building independence and self-efficacy, a place of wellness, avoiding institutionalization, and creating a culture of extended-hour dialysis), and community support (building social inclusion and supporting peers). Limitations Non-Māori and non-Pacific patient experiences of community house hemodialysis could not be explored. Conclusions Community house hemodialysis is a dialysis modality that overcomes many of the socioeconomic barriers to home hemodialysis, is socially and culturally acceptable to Māori and Pacific people, and supports extended-hour hemodialysis and thereby promotes more equitable access to best practice services. It is therefore a significant addition to independent hemodialysis options available for patients.

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Estimating Preference Scores in Conventional and Home Nocturnal Hemodialysis Patients

Cited by 12 publications

References 45 publications

Intensive home haemodialysis: benefits and barriers

Intensive home haemodialysis: benefits and barriers

Should Patients Remain on Intensive Hemodialysis Rather than Choosing to Receive a Kidney Transplant?

Patients’ Experiences of Community House Hemodialysis: A Qualitative Study

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