Abstract: SA-PO926
Home Dialysis Utilization by African-Americans Is Influenced by Psychosocial Factors
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
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Lea, Janice P., Emory University, Atlanta, Georgia, United States
- Ang, Joshua Benjamin, Philadelphia College of Osteopathic Medicine-GA, Duluth, Georgia, United States
- Cobb, Jason, Emory University School of Medicine, Atlanta, Georgia, United States
- Masud, Tahsin, Emory University, Atlanta, Georgia, United States
- Bailey, James L., Emory University School of Medicine, Atlanta, Georgia, United States
- Plantinga, Laura, Emory University, Atlanta, Georgia, United States
Background
Racial disparities have been reported in utilization of home dialysis modalities. While psychosocial factors are assumed to play a role, there is a paucity of definitive data. The aim of this study was to examine the relationship between psychosocial factors and the utilization of home dialysis among prevalent African-American dialysis patients.
Methods
Data were extracted from the initial comprehensive assessment performed by social workers for patients starting dialysis treatment between 2010- 2016. Our exposures were social worker-assessed psychosocial factors; depression/anxiety, substance abuse, marital status, employment status, and level of independence (daily social support, no ambulatory assistance, and community-dwelling). Our outcome was dialysis modality assignment: in-center hemodialysis (ICH), peritoneal dialysis (PD), or home hemodialysis (HHD). Statistical analysis was performed using ANOVA, t test, and Pearson’s chi-square.
Results
Of 1338 patients, 85 were on PD, and 18 on HHD. Our population is predominantly AA with 91% of ICH, 69% of PD, and 77% of HHD patients being AA. Compared to ICH patients, PD and HHD patients were younger, less likely to have history of substance abuse, and more likely to be employed and independent (Table 1). There was no difference in depression/anxiety across modalities. When just the AA sample (n=1094) was analyzed, history of substance abuse, employment status, and independence similarly varied between modalities.
Conclusion
Our results suggest that African-American ESRD patients who utilize home dialysis are more likely to be employed, live independently, and less likely to have substance abuse history. Comparisons of outcomes of home vs. in-center modalities should take these psychosocial factors into account. Further investigation of other factors which could inform targeted interventions to improve utilization of home dialysis is warranted.