The following is a summary of “Identifying Major Barriers to Home Dialysis (The IM-HOME Study): Findings From a National Survey of Patients, Care Partners, and Providers,” published in the June 2024 issue of Nephrology by Reddy et al.
Understanding the barriers to developing strategies and improving home dialysis is crucial.
Researchers conducted a retrospective study to identify the biggest barriers to home dialysis according to patients, care partners, and providers.
They formed a 7-member advisory board, including patients, care partners, and providers, to identify critical barriers (such as patient/care partner and provider-perceived barriers) to home dialysis. Using the insights, a survey was developed and distributed through associations. In it, participants ranked the top 3 barriers (quantitative) and described those barriers (qualitative). The results were analyzed quantitatively and qualitatively.
The results showed 522 responses (233 providers, 289 patients/care partners). The top barriers for patients/care partners were fear of performing home dialysis, lack of space, and needing home-based support. Providers highlighted poor patient education, limited support staff, and a lack of experienced staff. Qualitative analysis revealed 9 themes, minted education, financial disincentives, limited resources, high care burden, favoring in-center dialysis, fear and isolation, access inequities, provider perceptions, and patient/provider resilience.
Investigators concluded that since patients and providers see different top barriers to home dialysis, a mix of strategies was needed to tackle issues at home and in the clinic.
Source: ajkd.org/article/S0272-6386(24)00790-X/fulltext#%20
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