Home hemodialysis: beliefs, attitudes, and practice patterns

Area of Science:

• Nephrology
• Renal Replacement Therapy
• Patient Care Modalities

Background:

• Growing global interest in home hemodialysis (HHD) stems from evidence suggesting superiority over conventional hemodialysis (HD).
• Improved patient outcomes are linked to intensive HD schedules, ideally administered in the home setting.
• Limited universal uptake of HHD suggests a gap in understanding the barriers to its widespread implementation.

Purpose of the Study:

• To investigate the beliefs, attitudes, and practice patterns of healthcare providers regarding home hemodialysis (HHD).
• To identify the key barriers hindering the broader adoption of HHD therapy among patients requiring kidney dialysis.

Main Methods:

• A survey was distributed to healthcare providers involved in hemodialysis (HD) care.
• The survey was posted on the Nephrology Dialysis Transplantation-Educational (NDT-E) website.
• Two hundred and seventy-two responses were analyzed to understand HHD prevalence and provider perspectives.

Main Results:

• Significant variability exists in HHD prevalence across different units.
• A majority of physicians (55%) view home settings as ideal for intensive HD, with 21% open to non-home intensive HD.
• Key barriers identified include a lack of trained personnel (35%) and funding for home adaptation (50.4%).

Conclusions:

• Despite strong provider interest and perceived benefits, HHD remains inaccessible to many patients.
• Organizational, physician, and patient-related factors are modifiable and could enhance HHD provision.
• Further research into national and local barriers is crucial for developing interventions to facilitate HHD adoption.