Enhancing the Cardiovascular Safety of Hemodialysis Care: A Cluster-Randomized, Comparative Effectiveness Trial of Multimodal Provider Education and Patient Activation Interventions
Most people in the United States who have end-stage renal disease (ESRD) get hemodialysis therapy in a clinic for four hours at a time, three times a week. The stability of hemodialysis sessions varies, and session instability is linked to injury to the heart and other organs. Presently, the way to best improve the safety of the heart and other organs during dialysis is not clear. Dialysis clinics approach this problem differently, and there is variation among clinics in how often hemodialysis sessions become unstable.
In partnership with the National Kidney Foundation and dialysis facilities, we will test two interventions designed to increase the stability of patient dialysis. One intervention, multimodal provider education, focuses on dialysis facility care teams. It includes team training, online education, and checklists. Another intervention, patient activation, focuses on patients. It includes peer mentoring by trained ESRD patients. We will then conduct a study in 28 dialysis facilities across the U.S., with 7 facilities getting the provider education only; 7 getting the patient activation intervention only; 7 getting both interventions; and 7 getting no interventions. This study is expected to clarify whether these interventions can make dialysis safer for ESRD patients.
Funding Period: 10/1/2015 to 12/31/2020