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How to overcome barriers and establish a successful home HD program
Bessie A Young1, Christopher Chan, Christopher Blagg
1Veterans Affairs Puget Sound Health Care System, Kidney Research Institute, Division of Nephrology, University of Washington, Seattle, Washington 98108, USA. youngb@u.washington.edu
Clinical Journal of the American Society of Nephrology : CJASN
|October 6, 2012
Summary
Home hemodialysis (HD) offers efficient, frequent dialysis but remains underused. Overcoming patient, provider, and facility barriers is key to expanding this effective treatment option.
Area of Science:
- Nephrology
- Renal Replacement Therapy
- Dialysis Modalities
Background:
- Home hemodialysis (HD) is an underutilized yet efficient dialysis method in the US.
- Newer, user-friendly HD systems are increasing patient and provider interest.
- Despite benefits, widespread reluctance exists due to limited experience and program requirements.
Purpose of the Study:
- To review the barriers hindering home HD adoption.
- To identify challenges for patients, physicians, practices, and facilities.
- To propose strategies for establishing successful home HD programs.
Main Methods:
- In-depth review of existing literature and clinical experience.
- Analysis of barriers from patient, provider, and facility perspectives.
- Development of actionable recommendations for program implementation.
Main Results:
- Barriers include extensive patient training needs, nursing education requirements, and necessary infrastructure support.
- Physician and patient inexperience contributes significantly to reluctance.
- Successful programs require addressing these multifaceted challenges.
Conclusions:
- Home hemodialysis is a viable, potentially cost-effective option for frequent or extended dialysis.
- Addressing specific barriers related to training, education, and infrastructure is crucial.
- Overcoming reluctance through education and support can expand home HD accessibility.
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