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A Province-Wide Home Dialysis Program Review: Challenges, Strengths, and Future Strategies
Megan Borkum1,2, Micheli Bevilacqua1,2, Alexandra Romann2
1Division of Nephrology, The University of British Columbia, Vancouver, Canada.
Canadian Journal of Kidney Health and Disease
|March 17, 2025
Summary
British Columbia aims to optimize home dialysis rates by addressing professional biases and logistical barriers. Future initiatives focus on standardized screening, champion promotion, and enhanced peer support to improve patient outcomes.
Area of Science:
- Nephrology
- Health Services Research
- Public Health
Background:
- British Columbia (BC) maintains a high home dialysis prevalence (approx. 30%), exceeding the national average.
- The provincial kidney care program focuses on patient-centered, goal-oriented dialysis.
- A review was prompted to examine intake and attrition rates within a learning health system.
Purpose of the Study:
- To examine home dialysis intake and attrition rates in British Columbia.
- To identify barriers and opportunities for optimizing home dialysis outcomes.
- To inform strategies within a learning health system context.
Main Methods:
- A review of published articles and program reports.
- Analysis of the provincial kidney care program framework, including funding and committees.
- Structured evaluation of healthcare system dynamics, professional practices, and patient characteristics.
Main Results:
- Identified challenges include healthcare professional biases and logistical barriers in remote areas.
- Proposed initiatives include standardizing patient screening and promoting home dialysis champions.
- Recommendations involve adopting sustainable practices and expanding peer support networks.
Conclusions:
- A systematic approach is crucial for assessing and optimizing home dialysis programs.
- Addressing system-level barriers, professional education, and patient engagement is key.
- These efforts are essential for increasing home dialysis uptake and long-term sustainability.
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