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Program that support patients in receiving dialysis at home proves successful

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In 2016, BC Renal created a program to support kidney patients who have difficulty completing peritoneal dialysis (PD) independently, whereby trained professionals help patients complete PD in their own homes. A study evaluating the PD Assist Program over the past five years shows that it prolongs some patients’ duration on their preferred dialysis modality. As a result, patients are able to enjoy a better quality of life. The study was published earlier this year in Peritoneal Dialysis International.

Dialysis is a life-saving therapy for kidney patients, but it can be very time consuming and costly when patients have to transition from one form of dialysis to another. PD is an ideal therapy for many kidney patients because it can be done independently at home, reducing the transportation and monetary costs associated with multiple trips to a hemodialysis clinic each week.
 
But some people may have social, physical or cognitive barriers that prevent them from completing dialysis by themselves. Therefore, the PD Assist program was created to offer eligible people support in completing their PD at home. For example, program staff make home visits to help patients with setting up the dialysis equipment, dismantling the machine, or lifting heavy bags of dialysis fluid as needed.

“It’s a program for both patients on PD long-term, as well as patients who need a little short-term respite, for example if they broke an arm,” explains Shannon Wong, a nephrology fellow with the University of British Columbia, who helped lead the study evaluating the program.

In their study, Wong and her colleagues analyzed data collected between 2016 and 2021, assessing how long patients stayed in the program, and their outcomes by the time they left the program, e.g., death, received a transplant, or eventually transitioned to hemodialysis.

The results show that patients spent a median of 13.6 months in the PD Assist program, prolonging overall duration on PD by a little over a year. Of the patients who exited the program, 37.4% were able to use the service until they died.

“That’s actually a good outcome because it means that these patients were able to stay on their preferred modality until their time of death, rather than having to switch to hemodialysis,” explains Wong. “It means patients can stay home as long as possible, and be independent for as long as possible.”

Wong says she would be interested to see how the program could be expanded in the future to offer additional support and health monitoring: “For example, if staff who make home visits could measure blood pressure or adjust dialysis solutions – I think that would be very advantageous for our patients.”
 
 

 

 

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