Kidney Week

Abstract: SA-PO914

Survey of Patient Awareness of and Attitudes Towards Home Dialysis in New York City

Session Information

• Dialysis: Home Hemodialysis
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 702 Dialysis: Home Hemodialysis

Authors

• Liu, Frank, Rogosin Institute, New York, New York, United States

Frank Liu,

• Epstein, David L., Rogosin Institute, New York, New York, United States

David L. Epstein,

• Levine, Daniel, Rogosin Institute, New York, New York, United States

Daniel Levine,

• Baskharoun, Samuel, Frank H. Netter MD School of Medicine, New Haven, Connecticut, United States

Samuel Baskharoun,

• Lin, Jonathan T., Rogosin Institute, New York, New York, United States

Jonathan T. Lin,

• Gutgarts, Victoria, NYP-Weill Cornell, New York, New York, United States

Victoria Gutgarts,

• Phillips, Molly R., Rogosin Institute, New York, New York, United States

Molly R. Phillips,

• Farrukh, Omar, NYP-Weill Cornell, New York, New York, United States

Omar Farrukh,

• Lamba, Perola, NYP-Weill Cornell, New York, New York, United States

Perola Lamba,

• Srisung, Weeraporn, NYP-Weill Cornell, New York, New York, United States

Weeraporn Srisung,

• Parker, Thomas, Rogosin Institute, New York, New York, United States

Thomas Parker,

• Guo, Xunxi Susan, NYP-Weill Cornell, New York, New York, United States

Xunxi Susan Guo,

• Perlman, Alan, Rogosin Institute, New York, New York, United States

Alan Perlman,

Background

Since 2008, CMS regulations have obligated dialysis practitioners to inform in-unit hemodialysis(HD) patients about alternatives to in-unit HD, including home dialysis modalities. Despite this mandate, home dialysis remains underutilized nationwide with just 8.6% of prevalent patients performing any home modality. Home modalities are even more disproportionately underutilized in New York City (NYC), with only 3.6% of patients using a home modality. Because of the unique challenges faced by patients living an intensely urban setting such as NYC, we attempted to understand the factors that might be responsible for that underutilization.

Methods

The PRIMARY CARES (Primary Care Attitudes and Renal Replacement Selection) survey was performed in 7 HD units in the NYC area representing a diverse population of ethnicities, languages, and socioeconomic categories with the objective of assessing factors influencing the utilization of home dialysis.

Results

832 in-unit HD patients were approached and 511 completed the survey. Of these, 469 (92%) indicated they received education regarding any renal replacement modality. Of those, only 180 (35%) reported having been educated about home hemodialysis (HHD) and only 142 (28%) reported having been educated about peritoneal dialysis (PD). Of the 180 patients educated about HHD, 39 (21.7%) seriously considered the modality after receiving education. Only 5 (12.8%) of the 39 patients who seriously considered HHD came to the conclusion they “would never do HHD”. Of the 142 patients educated about PD, 61 (43%) seriously considered the modality after receiving education. Only 11 (18%) of patients who seriously considered PD came to the conclusion they “would never do PD”.

Conclusion

Patient awareness of home modalities remains poor despite mandated modalities education. A significant proportion of patients educated about home modalities seriously considered dialyzing at home, whereas only a small minority indicated they would never consider dialyzing at home after receiving that education. Our data suggests that there may be a large reservoir of home dialysis patients within the NYC in-unit HD population, and that current in-unit modalities education programs could be improved.