title: Predialysis education in practice: a questionnaire survey of centres with established programmes.
abstract: BACKGROUND
  There is growing evidence that renal replacement therapy option education (RRTOE) can result in enhanced quality of life, improved clinical outcomes, and reduced health care costs. However, there is still no detailed guidance on the optimal way to run such programmes. To help address this knowledge gap, an expert meeting was held in March 2013 to formulate a position statement on optimal ways to run RRTOE. Experts were selected from units that had extensive experience in RRTOE or were performing research in this field. Before the meeting, experts completed a pilot questionnaire on RRTOE in their own units. They also prepared feedback on how to modify this questionnaire for a large-scale study.
  
  
  METHODS
  A pilot, web-based questionnaire was used to obtain information on: the renal unit and patients, the education team, RRTOE processes and content, how quality is assessed, and funding.
  
  
  RESULTS
  Four nurses, 5 nephrologists and 1 clinical psychologist (9 renal units; 6 EU countries) participated. Nurses were almost always responsible for organising RRTOE. Nephrologists spent 7.5% (median) of their time on RRTOE. Education for the patient and family began several months before dialysis or according to disease progression. Key topics such as the 'impact of the disease' were covered by every unit, but only a few units described all dialysis modalities. Visits to the unit were almost always arranged. Materials came in a wide variety of forms and from a wide range of sources. Group education sessions were used in 3/9 centres. Expectations on the timing of patients' decisions on modality and permanent access differed substantially between centres. Common quality assurance measures were: patient satisfaction, course attendance, updated materials. Only 1 unit had a dedicated budget.
  
  
  CONCLUSIONS
  There were substantial variations in how RRTOE is run between the units. A modified version of this questionnaire will be used to assess RRTOE at a European level.
authors.affiliation: Unidad de Nefrología, Complejo Asistencial Universitario de León, León, Spain. mprietov@gmail.com.
authors.forename: Mario
authors.initials: M
authors.lastname: Prieto-Velasco
authors.forename: Corinne
authors.initials: C
authors.lastname: Isnard Bagnis
authors.forename: Jessica
authors.initials: J
authors.lastname: Dean
authors.forename: Tony
authors.initials: T
authors.lastname: Goovaerts
authors.forename: Stefan
authors.initials: S
authors.lastname: Melander
authors.forename: Andrew
authors.initials: A
authors.lastname: Mooney
authors.forename: Eva-Lena
authors.initials: EL
authors.lastname: Nilsson
authors.forename: Peter
authors.initials: P
authors.lastname: Rutherford
authors.forename: Carmen
authors.initials: C
authors.lastname: Trujillo
authors.forename: Roberto
authors.initials: R
authors.lastname: Zambon
authors.forename: Carlo
authors.initials: C
authors.lastname: Crepaldi
mesh_terms: D005060:Europe / Q000453:epidemiology; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D054625:Healthcare Disparities; D006801:Humans; D009398:Nephrology / Q000193:education* / Q000639:trends; D010348:Patient Care Team / Q000639:trends; D010353:Patient Education as Topic / Q000639:trends; D017060:Patient Satisfaction; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D016730:Program Development; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D006435:Renal Dialysis / Q000639:trends; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome