title: Pre-dialysis education and patient choice.
abstract: The discussion was initiated by a paper on the influence of a pre-dialysis education programme on the mode of renal replacement therapy by Goovaerts et al (NDT 2005). Barriers to the uptake of self-care treatment modalities, including late referral, limited availability of treatment options, reimbursement, support from staff and families, the requirement for a helper and the length of the training programmes for home haemodialysis (HD) were discussed by 21 participants from 12 countries. The 'take-home' messages from the discussion were that to optimise the uptake of self-care modalities, renal units should try to ensure the all patients who are able to choose are fully informed before starting dialysis, even if they are referred to the unit very late. Offering a wide range of treatment options to new patients, and allowing (or encouraging) home HD without a helper, may also increase the number of patients who start and stay on a self-care modality. It should be possible to provide an acceptable level of training, without compromising on safety, within 3 weeks if the patient is confident with needling.
authors.affiliation: Department of Renal Medicine, Leeds Teaching Hospitals NHS Trust, UK.
authors.forename: Lindley
authors.initials: L
authors.lastname: ElizabethJ
authors.forename: Linda
authors.initials: L
authors.lastname: Hanna
authors.forename: Diane
authors.initials: D
authors.lastname: Walker
authors.forename: Elisheva
authors.initials: E
authors.lastname: Milo
authors.forename: Thomy
authors.initials: T
authors.lastname: Koupatsiaris
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: De Vos
authors.forename: John
authors.initials: J
authors.lastname: Sedgewick
authors.forename: Karen
authors.initials: K
authors.lastname: Pugh-Clarke
authors.forename: Frankie
authors.initials: F
authors.lastname: O'Kane
authors.forename: Gillian
authors.initials: G
authors.lastname: Treloar
authors.forename: Marisa
authors.initials: M
authors.lastname: Pegoraro
authors.forename: Anna
authors.initials: A
authors.lastname: Marti
authors.forename: Riitta
authors.initials: R
authors.lastname: Muroma-Karttunen
authors.forename: Gareth
authors.initials: G
authors.lastname: Murcutt
authors.forename: Stanley
authors.initials: S
authors.lastname: Shaldon
authors.forename: Nic
authors.initials: N
authors.lastname: Hoenich
authors.forename: Don
authors.initials: D
authors.lastname: Brooks
authors.forename: Ken
authors.initials: K
authors.lastname: Pilley
authors.forename: Waltraud
authors.initials: W
authors.lastname: Küntzle
authors.forename: Tony
authors.initials: T
authors.lastname: Goovaerts
mesh_terms: D001294:Attitude to Health; D002755:Choice Behavior; D006297:Health Services Accessibility; D006801:Humans; D010353:Patient Education as Topic / Q000458:organization & administration*; D012017:Referral and Consultation; D006435:Renal Dialysis / Q000379:methods / Q000523:psychology; D012648:Self Care / Q000379:methods / Q000523:psychology; D013997:Time Factors