A breakthrough series collaborative to increase patient participation with hemodialysis tasks: A stepped wedge cluster randomised controlled trial.

<h4>Background</h4>Compared to in-centre, home hemodialysis is associated with superior outcomes. The impact on patient experience and clinical outcomes of consistently providing the choice and training to undertake hemodialysis-related treatment tasks in the in-centre setting is unknown...

Description complète

Enregistré dans:

Détails bibliographiques
Auteurs principaux:	James Fotheringham, Tania Barnes, Louese Dunn, Sonia Lee, Steven Ariss, Tracey Young, Stephen J Walters, Paul Laboi, Andy Henwood, Rachel Gair, Martin Wilkie
Format:	article
Langue:	EN
Publié:	Public Library of Science (PLoS) 2021
Sujets:	Medicine R Science Q
Accès en ligne:	https://doaj.org/article/08823529678d40cda0ea58b03bc1a562
Tags:	Ajouter un tag Pas de tags, Soyez le premier à ajouter un tag!

id	oai:doaj.org-article:08823529678d40cda0ea58b03bc1a562
record_format	dspace
spelling	oai:doaj.org-article:08823529678d40cda0ea58b03bc1a5622021-12-02T20:09:06ZA breakthrough series collaborative to increase patient participation with hemodialysis tasks: A stepped wedge cluster randomised controlled trial.1932-620310.1371/journal.pone.0253966https://doaj.org/article/08823529678d40cda0ea58b03bc1a5622021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253966https://doaj.org/toc/1932-6203<h4>Background</h4>Compared to in-centre, home hemodialysis is associated with superior outcomes. The impact on patient experience and clinical outcomes of consistently providing the choice and training to undertake hemodialysis-related treatment tasks in the in-centre setting is unknown.<h4>Methods</h4>A stepped-wedge cluster randomised trial in 12 UK renal centres recruited prevalent in-centre hemodialysis patients with sites randomised into early and late participation in a 12-month breakthrough series collaborative that included data collection, learning events, Plan-Study-Do-Act cycles, and teleconferences repeated every 6 weeks, underpinned by a faculty, co-production, materials and a nursing course. The primary outcome was the proportion of patients undertaking five or more hemodialysis-related tasks or home hemodialysis. Secondary outcomes included independent hemodialysis, quality of life, symptoms, patient activation and hospitalisation. ISRCTN Registration Number 93999549.<h4>Results</h4>586 hemodialysis patients were recruited. The proportion performing 5 or more tasks or home hemodialysis increased from 45.6% to 52.3% (205 to 244/449, difference 6.2%, 95% CI 1.4 to 11%), however after analysis by step the adjusted odds ratio for the intervention was 1.63 (95% CI 0.94 to 2.81, P = 0.08). 28.3% of patients doing less than 5 tasks at baseline performed 5 or more at the end of the study (69/244, 95% CI 22.2-34.3%, adjusted odds ratio 3.71, 95% CI 1.66-8.31). Independent or home hemodialysis increased from 7.5% to 11.6% (32 to 49/423, difference 4.0%, 95% CI 1.0-7.0), but the remaining secondary endpoints were unaffected.<h4>Conclusions</h4>Our intervention did not increase dialysis related tasks being performed by a prevalent population of centre based patients, but there was an increase in home hemodialysis as well as an increase in tasks among patients who were doing fewer than 5 at baseline. Further studies are required that examine interventions to engage people who dialyse at centres in their own care.James FotheringhamTania BarnesLouese DunnSonia LeeSteven ArissTracey YoungStephen J WaltersPaul LaboiAndy HenwoodRachel GairMartin WilkiePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0253966 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q James Fotheringham Tania Barnes Louese Dunn Sonia Lee Steven Ariss Tracey Young Stephen J Walters Paul Laboi Andy Henwood Rachel Gair Martin Wilkie A breakthrough series collaborative to increase patient participation with hemodialysis tasks: A stepped wedge cluster randomised controlled trial.
description	<h4>Background</h4>Compared to in-centre, home hemodialysis is associated with superior outcomes. The impact on patient experience and clinical outcomes of consistently providing the choice and training to undertake hemodialysis-related treatment tasks in the in-centre setting is unknown.<h4>Methods</h4>A stepped-wedge cluster randomised trial in 12 UK renal centres recruited prevalent in-centre hemodialysis patients with sites randomised into early and late participation in a 12-month breakthrough series collaborative that included data collection, learning events, Plan-Study-Do-Act cycles, and teleconferences repeated every 6 weeks, underpinned by a faculty, co-production, materials and a nursing course. The primary outcome was the proportion of patients undertaking five or more hemodialysis-related tasks or home hemodialysis. Secondary outcomes included independent hemodialysis, quality of life, symptoms, patient activation and hospitalisation. ISRCTN Registration Number 93999549.<h4>Results</h4>586 hemodialysis patients were recruited. The proportion performing 5 or more tasks or home hemodialysis increased from 45.6% to 52.3% (205 to 244/449, difference 6.2%, 95% CI 1.4 to 11%), however after analysis by step the adjusted odds ratio for the intervention was 1.63 (95% CI 0.94 to 2.81, P = 0.08). 28.3% of patients doing less than 5 tasks at baseline performed 5 or more at the end of the study (69/244, 95% CI 22.2-34.3%, adjusted odds ratio 3.71, 95% CI 1.66-8.31). Independent or home hemodialysis increased from 7.5% to 11.6% (32 to 49/423, difference 4.0%, 95% CI 1.0-7.0), but the remaining secondary endpoints were unaffected.<h4>Conclusions</h4>Our intervention did not increase dialysis related tasks being performed by a prevalent population of centre based patients, but there was an increase in home hemodialysis as well as an increase in tasks among patients who were doing fewer than 5 at baseline. Further studies are required that examine interventions to engage people who dialyse at centres in their own care.
format	article
author	James Fotheringham Tania Barnes Louese Dunn Sonia Lee Steven Ariss Tracey Young Stephen J Walters Paul Laboi Andy Henwood Rachel Gair Martin Wilkie
author_facet	James Fotheringham Tania Barnes Louese Dunn Sonia Lee Steven Ariss Tracey Young Stephen J Walters Paul Laboi Andy Henwood Rachel Gair Martin Wilkie
author_sort	James Fotheringham
title	A breakthrough series collaborative to increase patient participation with hemodialysis tasks: A stepped wedge cluster randomised controlled trial.
title_short	A breakthrough series collaborative to increase patient participation with hemodialysis tasks: A stepped wedge cluster randomised controlled trial.
title_full	A breakthrough series collaborative to increase patient participation with hemodialysis tasks: A stepped wedge cluster randomised controlled trial.
title_fullStr	A breakthrough series collaborative to increase patient participation with hemodialysis tasks: A stepped wedge cluster randomised controlled trial.
title_full_unstemmed	A breakthrough series collaborative to increase patient participation with hemodialysis tasks: A stepped wedge cluster randomised controlled trial.
title_sort	breakthrough series collaborative to increase patient participation with hemodialysis tasks: a stepped wedge cluster randomised controlled trial.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/08823529678d40cda0ea58b03bc1a562
work_keys_str_mv	AT jamesfotheringham abreakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT taniabarnes abreakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT louesedunn abreakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT sonialee abreakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT stevenariss abreakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT traceyyoung abreakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT stephenjwalters abreakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT paullaboi abreakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT andyhenwood abreakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT rachelgair abreakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT martinwilkie abreakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT jamesfotheringham breakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT taniabarnes breakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT louesedunn breakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT sonialee breakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT stevenariss breakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT traceyyoung breakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT stephenjwalters breakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT paullaboi breakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT andyhenwood breakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT rachelgair breakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial AT martinwilkie breakthroughseriescollaborativetoincreasepatientparticipationwithhemodialysistasksasteppedwedgeclusterrandomisedcontrolledtrial
_version_	1718375103071256576

A breakthrough series collaborative to increase patient participation with hemodialysis tasks: A stepped wedge cluster randomised controlled trial.

Documents similaires