How to overcome barriers and establish a successful home HD program.

Young BA, Chan C, Blagg C, Lockridge R, Golper T, Finkelstein F, Shaffer R, Mehrotra R, ASN Dialysis Advisory Group
Clin J Am Soc Nephrol. 2012 7 (12): 2023-32

PMID: 23037981 · PMCID: PMC3513750 · DOI:10.2215/CJN.07080712

Home hemodialysis (HD) is an underused dialysis modality in the United States, even though it provides an efficient and probably cost-effective way to provide more frequent or longer dialysis. With the advent of newer home HD systems that are easier for patients to learn, use, and maintain, patient and provider interest in home HD is increasing. Although barriers for providers are similar to those for peritoneal dialysis, home HD requires more extensive patient training, nursing education, and infrastructure support in order to maintain a successful program. In addition, because many physicians and patients do not have experience with home HD, reluctance to start home HD programs is widespread. This in-depth review describes barriers to home HD, focusing on patients, individual physicians and practices, and dialysis facilities, and offers suggestions for how to overcome these barriers and establish a successful home HD program.

MeSH Terms (8)

Education, Medical Education, Nursing Hemodialysis, Home Humans Kidney Failure, Chronic Patient Education as Topic Program Development Quality of Life

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