Centre variation in home dialysis uptake: A survey of kidney centre practice in relation to home dialysis organisation and delivery in England

Journal article

Damery, S., Lambie, Mark, Williams, Iestyn, Coyle, David, Fotheringham, James, Solis-Trapala, Ivonne, Allen, K., Potts, Jessica, Dikomitis, Lisa and Davies, S. 2024. Centre variation in home dialysis uptake: A survey of kidney centre practice in relation to home dialysis organisation and delivery in England. Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis. 44 (4), pp. 265-274. https://doi.org/10.1177/08968608241232200
AuthorsDamery, S., Lambie, Mark, Williams, Iestyn, Coyle, David, Fotheringham, James, Solis-Trapala, Ivonne, Allen, K., Potts, Jessica, Dikomitis, Lisa and Davies, S.
AbstractBackground: Disparities in home dialysis uptake across England suggest inequity and unexplained variation in access. We surveyed staff at all English kidney centres to identify patterns in service organisation/delivery and explore correlations with home therapy uptake, as part of a larger study (‘Inter-CEPt’), which aims to identify potentially modifiable factors to address observed variations. Methods: Between June and September 2022, staff working at English kidney centres were surveyed and individual responses combined into one centre-level response per question using predetermined data aggregation rules. Descriptive analysis described centre practices and their correlation with home dialysis uptake (proportion of new home dialysis starters) using 2019 UK Renal Registry 12-month home dialysis incidence data. Results: In total, 180 responses were received (50/51 centres, 98.0%). Despite varied organisation of home dialysis services, most components of service delivery and practice had minimal or weak correlations with home dialysis uptake apart from offering assisted peritoneal dialysis and ‘promoting flexible decision-making about dialysis modality’. Moderate to strong correlations were identified between home dialysis uptake and centres reporting supportive clinical leadership (correlation 0.32, 95% Confidence Interval (CI): 0.05–0.55), an organisational culture that values trying new initiatives (0.57, 95% CI: 0.34–0.73); support for reflective practice (0.38, 95% CI: 0.11–0.60), facilitating research engagement (0.39, 95% CI: 0.13–0.61) and promoting continuous quality improvement (0.29, 95% CI: 0.01–0.53). Conclusions: Uptake of home dialysis is likely to be driven by organisational culture, leadership and staff attitudes, which provide a supportive clinical environment within which specific components of service organisation and delivery can be effective.
KeywordsHome dialysis; Home haemodyalisis; Kidney centre; Kidney failure; Peritoneal dialysis; Survey; Update
Year2024
JournalPeritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Journal citation44 (4), pp. 265-274
PublisherSAGE Publications
ISSN0896-8608
1718-4304
Digital Object Identifier (DOI)https://doi.org/10.1177/08968608241232200
Official URLhttps://journals.sagepub.com/doi/10.1177/08968608241232200
Publication dates
Online06 Mar 2024
Publication process dates
Deposited18 Mar 2024
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Open
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Dikomitis, L. 2019. Images depicting headache pain – a tool to aid the diagnosis of cluster headache: a pilot study. Journal of Multidisciplinary Healthcare. 2019 (12), pp. 691-698. https://doi.org/10.2147/JMDH.S207128
Images depicting pain: a screening tool for cluster headache
Buture, A., Dikomitis, L., Boland, L. and Ahmed, F. 2018. Images depicting pain: a screening tool for cluster headache. Cephalalgia. 38 (Supp 1), pp. 114-115. https://doi.org/10.1177/0333102418789865
Delays in the diagnosis and misdiagnosis of cluster headache – a systematic literature review
Buture, A., Boland, J. W., Dikomitis, L. and Ahmed, F. 2018. Delays in the diagnosis and misdiagnosis of cluster headache – a systematic literature review. Cephalalgia. 38 (Supp 1), pp. MTIS2018-145.
Systematic literature review on the delays in the diagnosis and misdiagnosis of cluster headache
Buture, A., Boland, J. W., Dikomitis, L. and Ahmed, F. 2018. Systematic literature review on the delays in the diagnosis and misdiagnosis of cluster headache. Neurological Sciences. 40, pp. 25-39. https://doi.org/10.1007/s10072-018-3598-5
Visual images: an additional tool for the screening of cluster headache
Buture, A., Dikomitis, L., Boland, J. W. and Ahmed, F. 2017. Visual images: an additional tool for the screening of cluster headache. Cephalalgia. 37, p. 219.
So looking at this, you look like you've got some issues going on with your joints: Exploring case-finding in long-tern condition review consultations - the ENHANCE pilot trial
Liddle, J., Chew-Graham, C. A., Mallen, C. D., Healey, E. L., Jinks, C. and Dikomitis, L. 2017. So looking at this, you look like you've got some issues going on with your joints: Exploring case-finding in long-tern condition review consultations - the ENHANCE pilot trial. Rheumatology. 56 (IS 2). https://doi.org/10.1093/rheumatology/kex062.181
'"The man who closed the asylums": Franco Basaglia and the revolution in mental health care', by John Foot (Verso, 2015)
Dikomitis, L. 2016. '"The man who closed the asylums": Franco Basaglia and the revolution in mental health care', by John Foot (Verso, 2015). Durham University Institute for Medical Humanities.
How do clinicians think about cluster headache
Dikomitis, L., Paemeleire, K., Goadsby, P. J. and Ahmed, F. 2016. How do clinicians think about cluster headache. Cephalalgia. 36 (S 1).
Developing a diagnostic tool for the early diagnosis of cluster headache
Buture, A., Dikomitis, L. and Ahmed, F. 2016. Developing a diagnostic tool for the early diagnosis of cluster headache. Cephalalgia.
Perceptions, understandings and experiences of cluster headache patients in the north of England: a qualitative study
Dikomitis, L., Quarshie, V., Paemeleire, K., Goadsby, P. J. and Ahmed, F. 2015. Perceptions, understandings and experiences of cluster headache patients in the north of England: a qualitative study. Cephalalgia. 25 (S6).
[Review of] The Past in Pieces: Belonging in the New Cyprus, by Rebecca Bryant. Contemporary Ethnography series. Philadelphia: University of Pennsylvania Press, 2010. 224 pp.
Dikomitis, L. 2014. [Review of] The Past in Pieces: Belonging in the New Cyprus, by Rebecca Bryant. Contemporary Ethnography series. Philadelphia: University of Pennsylvania Press, 2010. 224 pp. American Anthropologist. 116 (1), pp. 194-195. https://doi.org/10.1111/aman.12085_9
Perceptions and experiences of cluster headache among patients, general practitioners and neurologists in the north of england: A qualitative study
Ahmed, F., Dikomitis, L., Zafar, H. W., Goadsby, P. and Paemeliere, P. 2014. Perceptions and experiences of cluster headache among patients, general practitioners and neurologists in the north of england: A qualitative study. Journal of Headache and Pain. 15 (S1).
Patients perceptions of the causes of migraine in Flanders (Belgium): A qualitative study
Dikomitis, L., Bonte, M., Willems, S. and Paemeleire, K. 2013. Patients perceptions of the causes of migraine in Flanders (Belgium): A qualitative study. Cephalalgia. 33 (S 8), p. 198. https://doi.org/10.1177/0333102413490487