Shared Decision Making Increases Living Kidney Transplantation and Peritoneal Dialysis

Area of Science:

• Nephrology
• Health Services Research
• Medical Ethics

Background:

• Taiwan's hospital accreditation promotes shared decision making (SDM) in healthcare.
• This study investigates the impact of SDM on treatment modality distribution for renal replacement therapy (RRT) in newly diagnosed end-stage renal disease (ESRD) patients.

Purpose of the Study:

• To evaluate changes in RRT treatment modality distribution before and after implementing SDM.
• To assess patient satisfaction with the SDM process for RRT.

Main Methods:

• SDM for RRT was facilitated by an internet-based educational program and smart system.
• The SDM project was implemented starting January 2017, with patients receiving RRT between January 2016 and December 2017 enrolled.

Main Results:

• In 2017, 220 out of 310 RRT patients completed SDM.
• SDM implementation was associated with a 38.5% increase in living kidney transplantation (KT) and a 112.9% increase in peritoneal dialysis (PD).
• Preemptive living KT increased from 1 to 5 patients, and 91.3% of patients were satisfied with SDM.

Conclusions:

• Implementing SDM before long-term RRT initiation leads to increased rates of living KT and PD therapy.
• Nationwide adoption of SDM for RRT could significantly boost living KT trends.
• SDM enhances patient engagement and satisfaction in RRT decision-making.