Dr. Megan Borkum presents her talk, “Findings related to the home therapies screening and referral project,” as part of BC Renal’s province-wide rounds.
0:04:20
Dr. Borkum begins by providing a brief overview of home therapies - e.g., home hemodialysis (HHD) and peritoneal dialysis (PD). She shares statistics on home dialysis in BC, noting an increase in the absolute number of patients on home dialysis in the province over recent years. She shares some data showing the benefits of home dialysis, noting that home PD is associated with better preservation of residual kidney function, fewer hospitalizations and better quality of life, while HHD is associated with better blood pressure, sleep and other benefits.
0:13:00 - Home therapies referral project
In 2022, an analysis by BC Renal revealed discrepancies in screening, referral, communication regarding home therapies across the province. As a result, a working group, literature review, and survey of patient partners was initiated. Key takeaways of the literature review include that many previous contradictions to PD are no longer relevant (e.g., obesity, laparoscopic insertion of catheters, liver disease, and osteotomies should no longer be considered a contradiction); screening tools and guides are limited with variable use; and that pre-dialysis modality education is essential (e.g., improves informed decision-making, promotes self-care, greater patient compliance, satisfaction).
0:19:55 - Environmental scan
Dr. Borkum provides an overview of the environmental scan done to assess home therapy use in BC. The results point to 5 home therapy referral pathway steps, including: identify, screen, offer home therapies, refer to home therapies, and home therapies confirmed. Dr. Borkum talks about these points in greater detail, for example noting that screening criteria for home therapies varies across the province. She highlights criteria where home therapy dialysis is absolutely contraindicated.
0:28:20 - Resources
Dr. Borkum talks about some resources BC Renal has created to support home therapy (e.g., “It’s better at home” home dialysis video series). As well, she talks about the home therapies suitability assessment, and barriers to and good examples of its use. Dr. Borkum presents a rough draft of a new home therapies document and collated pool of patient resources, which will be refined and shared in the coming months.
0:34:25 - Other findings
She shares additional information from the project, including survey response details and notes that home therapies champions are essential for uptake of home dialysis and keeping guidelines up to date. All patient partners surveyed emphasized the need for peer support in choosing modalities.
0:39:45 - Next steps for the guide
Next, the working group plans to assess the feasibility and useability of the new guide at five sites, which will eventually be refined and rolled out provincially, along with a media campaign, more education sessions for providers, and formalized roles for modality transition nurses.
0:42:15 - Summary and Q&A
Dr. Borkum shares her key takeaway points and takes questions from the audience.
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26 авг 2024
