title: Almost anyone can have home therapy but can we overcome the barriers?
abstract: BACKGROUND
  Home dialysis, including both peritoneal and haemodialysis, has been shown to improve patient wellbeing as well as being an economically beneficial alternative to hospital-based therapies.
  
  
  OBJECTIVE
  This paper discusses the major barriers to home therapies, particularly in relation to home haemodialysis (HHD) and systems that can be used to overcome them.
  
  
  RESULTS
  The use of HHD varies considerably between and within countries. The major limitation is lack of experience and education. A well-planned pre-dialysis education programme seems to be one essential key to the growth of home therapies.
  
  
  CONCLUSIONS
  Key points in providing a successful home therapy programme are a highly motivated multidisciplinary team including a dedicated nephrologist and high-level nursing expertise. In addition, an effective pre-dialysis education programme for identifying suitable patients is required.
authors: Helsinki University Hospital, Division of Nephrology, Homehemodialysis Unit, Haartmaninkatu 4, Rakennus 3, Helsinki, Finland. riitta.muroma-karttunen@hus.fi
authors: Riitta
authors: R
authors: Muroma-Karttunen
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000451:nursing / Q000523:psychology; D003299:Cooperative Behavior; D006437:Hemodialysis, Home / Q000379:methods / Q000451:nursing* / Q000523:psychology; D006801:Humans; D033183:Interdisciplinary Communication; D007676:Kidney Failure, Chronic / Q000451:nursing* / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010353:Patient Education as Topic / Q000379:methods; D018579:Patient Selection; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000379:methods / Q000451:nursing* / Q000523:psychology; D012648:Self Care / Q000379:methods / Q000523:psychology; D006113:United Kingdom