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Multi-center, pragmatic, cluster-randomized, controlled trial of standardized peritoneal dialysis (PD) training

Josephine S F Chow1,2,3,4,5, Neil Boudville6,7, Yeoungjee Cho8,9

  • 1South Western Sydney Local Health District, Liverpool, NSW, Australia. Josephine.Chow@health.nsw.gov.au.

Trials
|November 15, 2023
PubMed

Insights

The Targeted Education ApproaCH to improve Peritoneal Dialysis outcomes (TEACH-PD) trial investigates if standardized training reduces peritoneal dialysis (PD) infections. This approach aims to improve PD sustainability and patient outcomes by implementing ISPD guidelines.

Area of Science:

  • Nephrology
  • Clinical Trials
  • Infectious Disease Prevention

Background:

  • Peritoneal dialysis (PD)-related infections are a major challenge to the long-term success of PD therapy.
  • Standardized PD training curricula are lacking, potentially contributing to infection rates.
  • The Targeted Education ApproaCH to improve Peritoneal Dialysis outcomes (TEACH-PD) trial addresses this gap.

Purpose of the Study:

  • To evaluate if a standardized training curriculum, based on International Society for Peritoneal Dialysis (ISPD) guidelines, reduces PD-related infections compared to usual training.
  • To assess the impact of standardized training on various secondary outcomes including infection-associated catheter removal, transfer to hemodialysis, quality of life, hospitalization, and mortality.

Main Methods:

  • A registry-based, pragmatic, open-label, multi-center, binational, cluster-randomized controlled trial involving 42 PD treatment units in Australia and New Zealand.
  • Recruitment of adult patients (≥18 years) new to PD training between July 2019 and June 2023.
  • Randomization of clusters to either the standardized TEACH-PD training or usual training practice, with a minimum follow-up of 12 months (average 2 years).

Main Results:

  • Primary outcome: time to the first occurrence of any PD-related infection (exit site, tunnel, or peritonitis).
  • Secondary outcomes: individual infection components, catheter removal, transfer to hemodialysis, quality of life, hospitalization, all-cause death, and cost-effectiveness.
  • Data collected from the ANZ Dialysis and Transplant Registry (ANZDATA) and NZPD Registry.

Conclusions:

  • The TEACH-PD trial is designed to provide high-certainty evidence on the effectiveness of an ISPD guideline-informed standardized PD training curriculum.
  • Findings will inform best practices for PD nurse trainers and patients to prevent PD-related infections.
  • The study aims to enhance the sustainability of PD and improve patient care through evidence-based training.
Abstract

Keywords:
Cluster randomized controlled trialCompetency assessmentCost-effectivenessOutcomesPatient educationPeritoneal dialysisPeritonitisStandardized training

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