Developing and pilot testing a shared decision-making intervention for dialysis choice.

Area of Science:

• Nephrology
• Patient Care
• Health Services Research

Background:

• Evidence on guiding patient decisions for haemodialysis vs. peritoneal dialysis remains inconclusive.
• International guidelines advocate for patient involvement in dialysis modality selection.
• Studies indicate a consistent lack of patient involvement in this critical decision-making process.

Purpose of the Study:

• To develop and pilot test an intervention focused on shared decision-making for dialysis modality choice.
• To assess the feasibility of implementing shared decision-making tools in clinical practice.

Main Methods:

• The study involved two phases: intervention development and feasibility/piloting.
• The International Patient Decision Aid Standards guided the development of decision aids.
• Feasibility was assessed using the SDM Q9 and Decision Quality Measure (DQM) with 137 patients.

Main Results:

• The intervention was tested by 137 patients, leading to an increase in home dialysis selection.
• Post-intervention, 80% of patients chose home dialysis, a 23% increase compared to pre-study rates.
• The SDM Q9 confirmed that most patients perceived the intervention as effective shared decision-making.

Conclusions:

• Shared decision-making interventions, supported by decision aids, can enhance the uptake of home dialysis.
• The SDM Q9 and DQM proved to be feasible tools for evaluating shared decision-making interventions.
• Further research is necessary to explore patient experiences and the impact on dialysis modality choice.