Personalising haemodialysis treatment with incremental dialysis for incident patients with end-stage kidney disease: an implementation study protocol.

Autor:	Armstrong M; Medicine Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada marni.armstrong@ahs.ca.; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Wityk Martin TL; Medicine Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada., Zimmermann GL; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.; Alberta SPOR SUPPORT Unit, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada., Drall K; Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada., Pannu NI; Medicine Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada.; Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Jan 29; Vol. 14 (1), pp. e075195. Date of Electronic Publication: 2024 Jan 29.
DOI:	10.1136/bmjopen-2023-075195
Abstrakt:	Introduction: Incremental dialysis is a personalised dialysis prescription based on residual kidney function that allows for the initial use of shorter duration, less frequent and less intense dialysis. It has been associated with enhanced quality of life and decreased healthcare costs when compared with conventional dialysis. While nephrologists report prescribing incremental dialysis, few dialysis programmes offer a systematic approach in offering and evaluating its use. To move evidence into practice, and in order to improve the safety and quality of providing incremental dialysis care, we have designed an implementation study. This study aims to evaluate the systematic assessment of patients starting facility-based haemodialysis for eligibility for incremental dialysis, and the prescription and monitoring of incremental dialysis treatment. Methods and Analysis: A hybrid effectiveness and implementation study design is being used to evaluate the implementation of the programme at dialysis sites in Alberta, Canada. The Reach, Effectiveness, Adoption, Implementation and Maintenance framework will be used to capture individual-level and organisational-level impact of the project. Clinical outcomes related to kidney function will be monitored on an ongoing basis, and patient-reported outcomes and experience measures will be collected at baseline and then quarterly throughout the first year of dialysis. Ethics and Dissemination: The study was approved by the Health Research Ethics Board of the University of Alberta. The study is funded by the Strategic Clinical Networks of Alberta Health Services. The study will help answer important questions on the effectiveness of incremental dialysis, and inform the acceptability, adoption, feasibility, reach and sustainability of incremental dialysis within provision of haemodialysis care. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu