Acceptability of alternate-day in-centre haemodialysis: an evaluation
Research type
Research Study
Full title
An evaluation of patient and staff acceptability of alternate-day haemodialysis.
IRAS ID
178198
Contact name
Enric Vilar
Contact email
Sponsor organisation
East and North Herts NHS Trust
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
This study aims to explore the acceptability and barriers to alternate-day haemodialysis (HD) from a patient and staff perspective.
There is growing evidence that frequent HD regimes, which are usually delivered in the home setting, provide patient benefits. These include improved quality of life, reduction in risk of cardiovascular surrogate markers, reduced markers of inflammation, improved blood pressure, improved phosphate control, and improvement in dialysis-related symptoms including recovery from dialysis.
The vast majority of HD patients though remain on in-centre, usually thrice weekly dialysis and appear to be at increased risk of death after the long weekend break if they dialyse by a typical Monday/Wednesday/Friday or Tuesday/Thursday/Saturday regime. The reasons for the underlying increase in mortality after the weekend break are unclear.
It has been proposed that in-centre alternate-day HD, rather than thrice weekly HD could provide patients with some of the benefits of a frequent dialysis regime. It is thought that alternate-day HD might attenuate or even eliminate the mortality increase that occurs after a weekend break following a thrice weekly regime, and improve patient quality of life.
In this study we propose a preliminary project that would inform a feasibility study in order to determine the acceptability of in-centre alternate-day HD. A prospective comparative study of alternate-day HD versus thrice weekly dialysis would by necessity involve alterations to the operational organisation of HD units involved in such a project, so preliminary work is necessary to guide the design of such a study and to overcome and address any potential barriers.
We will use information obtained from interviews and focus groups with patients and staff to determine factors that may be important to patients in deciding whether they might consider an alternate-day dialysis regime acceptable, after which we will conduct a survey of patients at eight dialysis units.
REC name
London - City & East Research Ethics Committee
REC reference
15/LO/0966
Date of REC Opinion
5 Jun 2015
REC opinion
Further Information Favourable Opinion