Anna Machowska|Mark Dominik Alscher|Satyanarayana Reddy Vanga|Michael Koch|Michael Aarup|Abdul Rashid Qureshi|Bengt Lindholm|Peter Rutherford
Factors influencing access to education, decision making, and receipt of preferred dialysis modality in unplanned dialysis start patients
Baxter (Sweden)|Karolinska Institutet|Robert Bosch Hospital|Royal Stoke University Hospital|Odense University Hospital|Baxter (Sweden)|Karolinska Institutet|Baxter (Sweden)|Karolinska Institutet|Baxter (Switzerland)
objectives unplanned dialysis start ups leads worse clinical outcomes planned start minority patients ever receive education topic able make modality choice particularly home dialysisthis study aimed determine predictive factors patients receiving education making decision receiving preferred modality choice ups patients following ups educational program upsepmethods offering patients therapy options unplanned start options study examined impact implementation specific upsep including decision support tools pathway improvement dialysis modality choicelinear regression models used examine factors predicting three key steps referral receipt upsep modality decision making actual delivery preferred modality choicea simple economic assessment performed examine potential benefit implementing upsep terms dialysis costsresults majority ups patients could receive upsep 214270 patients able make decision 177214 although patients received preferred choice 159177regression analysis demonstrated initial dialysis modality predictive factor referral receipt upsep modality decision makingin contrast age predictor referral receipt upsep comorbidity predictor step except myocardial infarction weak predictor lower likelihood receiving preferred modalitycountry practices predicted upsep receipt decision makingeconomic analysis demonstrated potential benefit upsep implementation dialysis modality costs associated modality distribution driven patient preferenceconclusion education decision support allow ups patients understand options choose dialysis modality attention needs focused ensuring equity access educational programs especially elderlyphysician practice culture across units countries important predictor ups patient management modality choice independent patientrelated factorsadditional work required understand improve patient pathways ensure modality preference enactedthere appears cost benefit delivering education supporting choice ensuring choice enacted ups patients