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  3. Identifying Major Barriers To Home Dialysis (the Im-home Study): Findings From A National Survey Of Patients, Care Partners, And Providers.
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  3. Identifying Major Barriers To Home Dialysis (the Im-home Study): Findings From A National Survey Of Patients, Care Partners, And Providers.

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Identifying Major Barriers to Home Dialysis (The IM-HOME Study): Findings From a National Survey of Patients, Care

Yuvaram N V Reddy1, Matthew D Kearney2, Michaela Ward3

  • 1Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, Philadelphia, Pennsylvania; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania; Center for Health Equity Research and Promotion, Corporal Crescenz VA Medical Center, Philadelphia, Pennsylvania.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|June 8, 2024

View abstract on PubMed

Summary
This summary is machine-generated.

Patients and providers perceive different barriers to home dialysis. Addressing both patient fears and provider concerns like education is key to increasing home dialysis use.

Keywords:
Barriershome dialysisimplementation sciencemixed methodsperitoneal dialysissurvey

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Area of Science:

  • Nephrology
  • Patient Care
  • Healthcare Delivery

Background:

  • Improving home dialysis utilization is crucial for patient outcomes and healthcare system efficiency.
  • A comprehensive understanding of barriers from multiple stakeholder perspectives is needed to develop effective strategies.
  • Current knowledge gaps exist regarding the most significant barriers to home dialysis from patient, care partner, and provider viewpoints.

Purpose of the Study:

  • To identify and rank the most important barriers to home dialysis use.
  • To compare barriers as perceived by patients, care partners, and healthcare providers.
  • To inform the development of targeted interventions to increase home dialysis adoption.

Main Methods:

  • Convergent parallel mixed-methods study involving a 7-member advisory board.
  • Development of a survey based on expert-identified barriers, distributed to patients, care partners, and providers.
  • Quantitative ranking of top barriers and qualitative content analysis of open-ended responses.

    • Main Results:

    • 522 complete responses were analyzed (233 providers, 289 patients/care partners).
    • Top patient/care partner barriers: fear of home dialysis, lack of space, need for home support.
    • Top provider barriers: poor patient education, limited support mechanisms, lack of experienced staff.

    Conclusions:

    • Significant discrepancies exist between patient/care partner and provider-identified barriers to home dialysis.
    • Addressing both patient-centric concerns (e.g., fear, space) and provider-centric issues (e.g., education, staffing) is essential.
    • Developing diverse, targeted strategies is necessary to overcome the multifaceted barriers and promote home dialysis.