The Concordance between Patients' Renal Replacement Therapy Choice and Definitive Modality: Is It a Utopia?
It is desirable for patients to play active roles in the choice of renal replacement therapy (RRT). Patient decision aid tools (PDAs) have been developed to allow the patients to choose the option best suited to their individual needs. An observational, prospective registry was conducted in 26 Spani...
Gespeichert in:
| Veröffentlicht in: | PloS one 2015-10, Vol.10 (10), p.e0138811-e0138811 |
|---|---|
| Hauptverfasser: | , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e0138811 |
|---|---|
| container_issue | 10 |
| container_start_page | e0138811 |
| container_title | PloS one |
| container_volume | 10 |
| creator | Prieto-Velasco, Mario Quiros, Pedro Remon, Cesar |
| description | It is desirable for patients to play active roles in the choice of renal replacement therapy (RRT). Patient decision aid tools (PDAs) have been developed to allow the patients to choose the option best suited to their individual needs.
An observational, prospective registry was conducted in 26 Spanish hospitals between September 2010 and May 2012. The results of the patients' choice and the definitive RRT modality were registered through the progressive implementation of an Education Process (EP) with PDAs designed to help Chronic Kidney Disease (CKD) patients choose RRT.
Patients included in this study: 1044. Of these, 569 patients used PDAs and had made a definitive choice by the end of registration. A total of 88.4% of patients chose dialysis [43% hemodialysis (HD) and 45% peritoneal dialysis (PD)] 3.2% preemptive living-donor transplant (TX), and 8.4% conservative treatment (CT). A total of 399 patients began RRT during this period. The distribution was 93.4% dialysis (53.6% HD; 40% PD), 1.3% preemptive TX and 5.3% CT. The patients who followed the EP changed their mind significantly less often [kappa value of 0.91 (95% CI, 0.86-0.95)] than those who did not follow it, despite starting unplanned treatment [kappa value of 0.85 (95% CI, 0.75-0.95]. A higher agreement between the final choice and a definitive treatment was achieved by the EP and planned patients [kappa value of 0.93 (95% CI, 0.89-0.98)]. Those who did not go through the EP had a much lower index of choosing PD and changed their decision more frequently when starting definitive treatment [kappa value of 0.73 (95% CI, 0.55-0.91)].
Free choice, assisted by PDAs, leads to a 50/50 distribution of PD and HD choice and an increase in TX choice. The use of PDAs, even with an unplanned start, achieved a high level of concordance between the chosen and definitive modality. |
| doi_str_mv | 10.1371/journal.pone.0138811 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_1722187852</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A431582866</galeid><doaj_id>oai_doaj_org_article_c7dfc5fb36ad407caedd910f676af6c3</doaj_id><sourcerecordid>A431582866</sourcerecordid><originalsourceid>FETCH-LOGICAL-c692t-9931c363fcb1237645186bb01fec6226e93f62e4a350de83057d7e51c8c2c0983</originalsourceid><addsrcrecordid>eNqNk11v0zAUhiMEYmPwDxBYQuLjosUfiZNwAZrKV6WhobFxazn2ceuS2iF2Bv33uDSbVrQLZCm2Tp73PfaxT5Y9JnhKWEler_zQO9lOO-9gigmrKkLuZIekZnTCKWZ3b6wPsgchrDAuWMX5_eyA8pxzVpWH2Y_zJaCZd8r3WjoFqIH4C8ChrzJacDG8QGeQ0qRv10oF6xRDSdPLboNmS2-TRDqN3oOxzkZ7CeiL17K1cfMGzQOaRyTRRfSdle8eZveMbAM8Guej7OLjh_PZ58nJ6af57PhkonhN46SuGVGMM6MaQlnJ84JUvGkwMaA4pRxqZjiFXLICa6gYLkpdQkFUpajCdcWOsqc73671QYx1CoKUlJKqrAqaiPmO0F6uRNfbtew3wksr_gZ8vxCyj1a1IFSpjSpMw7jUOS6VBK1rgg0vuTRcseT1dsw2NGvQKhWol-2e6f4fZ5di4S9FztPO6zIZvBwNev9zgBDF2gYFbSsd-GG375oWaUros3_Q2083UguZDmCd8Smv2pqK45yRoqLpFSRqeguVhoa1VelRGZvie4JXe4LERPgdF3IIQcy_nf0_e_p9n31-g12CbOMy-HaI1ruwD-Y7UPU-hB7MdZEJFtueuKqG2PaEGHsiyZ7cvKBr0VUTsD_nRAXZ</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1722187852</pqid></control><display><type>article</type><title>The Concordance between Patients' Renal Replacement Therapy Choice and Definitive Modality: Is It a Utopia?</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Public Library of Science (PLoS)</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Prieto-Velasco, Mario ; Quiros, Pedro ; Remon, Cesar</creator><contributor>Burdmann, Emmanuel A</contributor><creatorcontrib>Prieto-Velasco, Mario ; Quiros, Pedro ; Remon, Cesar ; Spanish Group for the Implementation of a Shared Decision Making Process for RRT Choice with Patient Decision Aid Tools ; Burdmann, Emmanuel A</creatorcontrib><description>It is desirable for patients to play active roles in the choice of renal replacement therapy (RRT). Patient decision aid tools (PDAs) have been developed to allow the patients to choose the option best suited to their individual needs.
An observational, prospective registry was conducted in 26 Spanish hospitals between September 2010 and May 2012. The results of the patients' choice and the definitive RRT modality were registered through the progressive implementation of an Education Process (EP) with PDAs designed to help Chronic Kidney Disease (CKD) patients choose RRT.
Patients included in this study: 1044. Of these, 569 patients used PDAs and had made a definitive choice by the end of registration. A total of 88.4% of patients chose dialysis [43% hemodialysis (HD) and 45% peritoneal dialysis (PD)] 3.2% preemptive living-donor transplant (TX), and 8.4% conservative treatment (CT). A total of 399 patients began RRT during this period. The distribution was 93.4% dialysis (53.6% HD; 40% PD), 1.3% preemptive TX and 5.3% CT. The patients who followed the EP changed their mind significantly less often [kappa value of 0.91 (95% CI, 0.86-0.95)] than those who did not follow it, despite starting unplanned treatment [kappa value of 0.85 (95% CI, 0.75-0.95]. A higher agreement between the final choice and a definitive treatment was achieved by the EP and planned patients [kappa value of 0.93 (95% CI, 0.89-0.98)]. Those who did not go through the EP had a much lower index of choosing PD and changed their decision more frequently when starting definitive treatment [kappa value of 0.73 (95% CI, 0.55-0.91)].
Free choice, assisted by PDAs, leads to a 50/50 distribution of PD and HD choice and an increase in TX choice. The use of PDAs, even with an unplanned start, achieved a high level of concordance between the chosen and definitive modality.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0138811</identifier><identifier>PMID: 26466387</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Aged ; Analysis ; Care and treatment ; Choice Behavior ; Chronic kidney failure ; Collaboration ; Concordances ; Decision Making ; Decision Support Techniques ; Dialysis ; Education ; Female ; Health Knowledge, Attitudes, Practice ; Hemodialysis ; Hospitals ; Humans ; Kidney Failure, Chronic - pathology ; Kidney Failure, Chronic - psychology ; Kidney Failure, Chronic - therapy ; Male ; Middle Aged ; Mortality ; Nephrology ; Patient compliance ; Patient outcomes ; Patient Participation - psychology ; Patient Participation - statistics & numerical data ; Patients ; Peritoneal dialysis ; Peritoneum ; Preempting ; Prospective Studies ; Registries ; Renal Dialysis - methods ; Renal Dialysis - psychology ; Renal replacement therapy ; Spain ; Studies ; Therapy ; Transplants & implants</subject><ispartof>PloS one, 2015-10, Vol.10 (10), p.e0138811-e0138811</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Prieto-Velasco et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Prieto-Velasco et al 2015 Prieto-Velasco et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-9931c363fcb1237645186bb01fec6226e93f62e4a350de83057d7e51c8c2c0983</citedby><cites>FETCH-LOGICAL-c692t-9931c363fcb1237645186bb01fec6226e93f62e4a350de83057d7e51c8c2c0983</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4605797/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4605797/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26466387$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Burdmann, Emmanuel A</contributor><creatorcontrib>Prieto-Velasco, Mario</creatorcontrib><creatorcontrib>Quiros, Pedro</creatorcontrib><creatorcontrib>Remon, Cesar</creatorcontrib><creatorcontrib>Spanish Group for the Implementation of a Shared Decision Making Process for RRT Choice with Patient Decision Aid Tools</creatorcontrib><title>The Concordance between Patients' Renal Replacement Therapy Choice and Definitive Modality: Is It a Utopia?</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>It is desirable for patients to play active roles in the choice of renal replacement therapy (RRT). Patient decision aid tools (PDAs) have been developed to allow the patients to choose the option best suited to their individual needs.
An observational, prospective registry was conducted in 26 Spanish hospitals between September 2010 and May 2012. The results of the patients' choice and the definitive RRT modality were registered through the progressive implementation of an Education Process (EP) with PDAs designed to help Chronic Kidney Disease (CKD) patients choose RRT.
Patients included in this study: 1044. Of these, 569 patients used PDAs and had made a definitive choice by the end of registration. A total of 88.4% of patients chose dialysis [43% hemodialysis (HD) and 45% peritoneal dialysis (PD)] 3.2% preemptive living-donor transplant (TX), and 8.4% conservative treatment (CT). A total of 399 patients began RRT during this period. The distribution was 93.4% dialysis (53.6% HD; 40% PD), 1.3% preemptive TX and 5.3% CT. The patients who followed the EP changed their mind significantly less often [kappa value of 0.91 (95% CI, 0.86-0.95)] than those who did not follow it, despite starting unplanned treatment [kappa value of 0.85 (95% CI, 0.75-0.95]. A higher agreement between the final choice and a definitive treatment was achieved by the EP and planned patients [kappa value of 0.93 (95% CI, 0.89-0.98)]. Those who did not go through the EP had a much lower index of choosing PD and changed their decision more frequently when starting definitive treatment [kappa value of 0.73 (95% CI, 0.55-0.91)].
Free choice, assisted by PDAs, leads to a 50/50 distribution of PD and HD choice and an increase in TX choice. The use of PDAs, even with an unplanned start, achieved a high level of concordance between the chosen and definitive modality.</description><subject>Aged</subject><subject>Analysis</subject><subject>Care and treatment</subject><subject>Choice Behavior</subject><subject>Chronic kidney failure</subject><subject>Collaboration</subject><subject>Concordances</subject><subject>Decision Making</subject><subject>Decision Support Techniques</subject><subject>Dialysis</subject><subject>Education</subject><subject>Female</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Hemodialysis</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Kidney Failure, Chronic - pathology</subject><subject>Kidney Failure, Chronic - psychology</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nephrology</subject><subject>Patient compliance</subject><subject>Patient outcomes</subject><subject>Patient Participation - psychology</subject><subject>Patient Participation - statistics & numerical data</subject><subject>Patients</subject><subject>Peritoneal dialysis</subject><subject>Peritoneum</subject><subject>Preempting</subject><subject>Prospective Studies</subject><subject>Registries</subject><subject>Renal Dialysis - methods</subject><subject>Renal Dialysis - psychology</subject><subject>Renal replacement therapy</subject><subject>Spain</subject><subject>Studies</subject><subject>Therapy</subject><subject>Transplants & implants</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk11v0zAUhiMEYmPwDxBYQuLjosUfiZNwAZrKV6WhobFxazn2ceuS2iF2Bv33uDSbVrQLZCm2Tp73PfaxT5Y9JnhKWEler_zQO9lOO-9gigmrKkLuZIekZnTCKWZ3b6wPsgchrDAuWMX5_eyA8pxzVpWH2Y_zJaCZd8r3WjoFqIH4C8ChrzJacDG8QGeQ0qRv10oF6xRDSdPLboNmS2-TRDqN3oOxzkZ7CeiL17K1cfMGzQOaRyTRRfSdle8eZveMbAM8Guej7OLjh_PZ58nJ6af57PhkonhN46SuGVGMM6MaQlnJ84JUvGkwMaA4pRxqZjiFXLICa6gYLkpdQkFUpajCdcWOsqc73671QYx1CoKUlJKqrAqaiPmO0F6uRNfbtew3wksr_gZ8vxCyj1a1IFSpjSpMw7jUOS6VBK1rgg0vuTRcseT1dsw2NGvQKhWol-2e6f4fZ5di4S9FztPO6zIZvBwNev9zgBDF2gYFbSsd-GG375oWaUros3_Q2083UguZDmCd8Smv2pqK45yRoqLpFSRqeguVhoa1VelRGZvie4JXe4LERPgdF3IIQcy_nf0_e_p9n31-g12CbOMy-HaI1ruwD-Y7UPU-hB7MdZEJFtueuKqG2PaEGHsiyZ7cvKBr0VUTsD_nRAXZ</recordid><startdate>20151014</startdate><enddate>20151014</enddate><creator>Prieto-Velasco, Mario</creator><creator>Quiros, Pedro</creator><creator>Remon, Cesar</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20151014</creationdate><title>The Concordance between Patients' Renal Replacement Therapy Choice and Definitive Modality: Is It a Utopia?</title><author>Prieto-Velasco, Mario ; Quiros, Pedro ; Remon, Cesar</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-9931c363fcb1237645186bb01fec6226e93f62e4a350de83057d7e51c8c2c0983</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Analysis</topic><topic>Care and treatment</topic><topic>Choice Behavior</topic><topic>Chronic kidney failure</topic><topic>Collaboration</topic><topic>Concordances</topic><topic>Decision Making</topic><topic>Decision Support Techniques</topic><topic>Dialysis</topic><topic>Education</topic><topic>Female</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Hemodialysis</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Kidney Failure, Chronic - pathology</topic><topic>Kidney Failure, Chronic - psychology</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Nephrology</topic><topic>Patient compliance</topic><topic>Patient outcomes</topic><topic>Patient Participation - psychology</topic><topic>Patient Participation - statistics & numerical data</topic><topic>Patients</topic><topic>Peritoneal dialysis</topic><topic>Peritoneum</topic><topic>Preempting</topic><topic>Prospective Studies</topic><topic>Registries</topic><topic>Renal Dialysis - methods</topic><topic>Renal Dialysis - psychology</topic><topic>Renal replacement therapy</topic><topic>Spain</topic><topic>Studies</topic><topic>Therapy</topic><topic>Transplants & implants</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Prieto-Velasco, Mario</creatorcontrib><creatorcontrib>Quiros, Pedro</creatorcontrib><creatorcontrib>Remon, Cesar</creatorcontrib><creatorcontrib>Spanish Group for the Implementation of a Shared Decision Making Process for RRT Choice with Patient Decision Aid Tools</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Prieto-Velasco, Mario</au><au>Quiros, Pedro</au><au>Remon, Cesar</au><au>Burdmann, Emmanuel A</au><aucorp>Spanish Group for the Implementation of a Shared Decision Making Process for RRT Choice with Patient Decision Aid Tools</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Concordance between Patients' Renal Replacement Therapy Choice and Definitive Modality: Is It a Utopia?</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-10-14</date><risdate>2015</risdate><volume>10</volume><issue>10</issue><spage>e0138811</spage><epage>e0138811</epage><pages>e0138811-e0138811</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>It is desirable for patients to play active roles in the choice of renal replacement therapy (RRT). Patient decision aid tools (PDAs) have been developed to allow the patients to choose the option best suited to their individual needs.
An observational, prospective registry was conducted in 26 Spanish hospitals between September 2010 and May 2012. The results of the patients' choice and the definitive RRT modality were registered through the progressive implementation of an Education Process (EP) with PDAs designed to help Chronic Kidney Disease (CKD) patients choose RRT.
Patients included in this study: 1044. Of these, 569 patients used PDAs and had made a definitive choice by the end of registration. A total of 88.4% of patients chose dialysis [43% hemodialysis (HD) and 45% peritoneal dialysis (PD)] 3.2% preemptive living-donor transplant (TX), and 8.4% conservative treatment (CT). A total of 399 patients began RRT during this period. The distribution was 93.4% dialysis (53.6% HD; 40% PD), 1.3% preemptive TX and 5.3% CT. The patients who followed the EP changed their mind significantly less often [kappa value of 0.91 (95% CI, 0.86-0.95)] than those who did not follow it, despite starting unplanned treatment [kappa value of 0.85 (95% CI, 0.75-0.95]. A higher agreement between the final choice and a definitive treatment was achieved by the EP and planned patients [kappa value of 0.93 (95% CI, 0.89-0.98)]. Those who did not go through the EP had a much lower index of choosing PD and changed their decision more frequently when starting definitive treatment [kappa value of 0.73 (95% CI, 0.55-0.91)].
Free choice, assisted by PDAs, leads to a 50/50 distribution of PD and HD choice and an increase in TX choice. The use of PDAs, even with an unplanned start, achieved a high level of concordance between the chosen and definitive modality.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26466387</pmid><doi>10.1371/journal.pone.0138811</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2015-10, Vol.10 (10), p.e0138811-e0138811 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1722187852 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Aged Analysis Care and treatment Choice Behavior Chronic kidney failure Collaboration Concordances Decision Making Decision Support Techniques Dialysis Education Female Health Knowledge, Attitudes, Practice Hemodialysis Hospitals Humans Kidney Failure, Chronic - pathology Kidney Failure, Chronic - psychology Kidney Failure, Chronic - therapy Male Middle Aged Mortality Nephrology Patient compliance Patient outcomes Patient Participation - psychology Patient Participation - statistics & numerical data Patients Peritoneal dialysis Peritoneum Preempting Prospective Studies Registries Renal Dialysis - methods Renal Dialysis - psychology Renal replacement therapy Spain Studies Therapy Transplants & implants |
| title | The Concordance between Patients' Renal Replacement Therapy Choice and Definitive Modality: Is It a Utopia? |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T05%3A12%3A55IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20Concordance%20between%20Patients'%20Renal%20Replacement%20Therapy%20Choice%20and%20Definitive%20Modality:%20Is%20It%20a%20Utopia?&rft.jtitle=PloS%20one&rft.au=Prieto-Velasco,%20Mario&rft.aucorp=Spanish%20Group%20for%20the%20Implementation%20of%20a%20Shared%20Decision%20Making%20Process%20for%20RRT%20Choice%20with%20Patient%20Decision%20Aid%20Tools&rft.date=2015-10-14&rft.volume=10&rft.issue=10&rft.spage=e0138811&rft.epage=e0138811&rft.pages=e0138811-e0138811&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0138811&rft_dat=%3Cgale_plos_%3EA431582866%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1722187852&rft_id=info:pmid/26466387&rft_galeid=A431582866&rft_doaj_id=oai_doaj_org_article_c7dfc5fb36ad407caedd910f676af6c3&rfr_iscdi=true |