Review
Transplantation
Micha Jongejan, Sanne de Lange, Willem Jan W. Bos, Arwen H. Pieterse, Wanda S. Konijn, Marjolijn van Buren, Alferso C. Abrahams, Mathijs van Oevelen
Summary: By focusing on the perspective of patients, a wide range of patient experiences and preferences regarding the decision-making process between dialysis and CC were identified. Patients lack awareness about CC, need more decision support, and factors such as maintaining quality of life, reducing treatment burden of dialysis, and not being a burden to others influence their choice.
NEPHROLOGY DIALYSIS TRANSPLANTATION
(2023)
Review
Urology & Nephrology
Pavithra Sakthivel, Alyaa Mostafa, Olalekan Lee Aiyegbusi
Summary: This systematic review aims to identify the key factors that influence the selection of conservative management for end-stage renal disease. The study found that patient-specific factors, clinician-specific factors, organizational factors, and national and international factors all play a role in the decision-making process. Improving education and generating stronger evidence are crucial for better guidance and recommendations for clinicians.
CLINICAL KIDNEY JOURNAL
(2023)
Article
Health Care Sciences & Services
Danielle Marie Muscat, Rachel Thompson, Erin Cvejic, Jenna Smith, Edward Hoi-fan Chang, Marguerite Tracy, Joshua Zadro, Robyn Lindner, Kirsten J. J. McCaffery
Summary: This study evaluated the impact of Choosing Wisely questions on consumers' decision-making outcomes. The results showed that both the Choosing Wisely questions and a shared decision-making preparation video increased intention to engage in shared decision-making, with the combination of both interventions having the greatest effect.
MEDICAL DECISION MAKING
(2023)
Review
Nursing
Eun Young Kim, Youn-Jung Son
Summary: This study systematically reviewed and synthesized qualitative evidence on decision-making for treatment modalities among older adults with end-stage renal disease. The findings suggest that older adults have varying preferences influenced by factors such as the possibility of dialysis and practical applicability of treatment options. The results emphasize the importance of tailored shared decision-making for individualized patient-centered care.
JOURNAL OF ADVANCED NURSING
(2022)
Article
Urology & Nephrology
Sepide Ghodsian, Mansour Ghafourifard, Akram Ghahramanian
Summary: Shared decision making is crucial in choosing dialysis modality, with peritoneal dialysis patients showing higher scores than hemodialysis patients. There are significant differences in SDM scores based on patients' age, education level, and income.
Article
Health Care Sciences & Services
Rajni Lal, Tessa O'Halloran, Ramai Santhirapala, Jugdeep Dhesi, Judith Partridge
Summary: This study aimed to assess and improve the quality and consistency of documentation regarding shared decision making (SDM) in the setting of peri-operative medicine. The results showed that interventions such as using a SDM tool, clinic posters, patient leaflets, and education sessions significantly improved documentation compliance and satisfaction of patients and professionals in SDM.
JOURNAL OF EVALUATION IN CLINICAL PRACTICE
(2023)
Article
Health Care Sciences & Services
Jennifer St. Clair Russell, Andrea Oliverio, Amber Paulus
Summary: Through telephone interviews and focus group discussions, barriers to discussions about conservative management of patients with kidney failure were identified among nephrologists and fellows. While there were common barriers, differences in perceptions were found based on experience level. Nephrologists viewed discordant opinions among patient and family as the biggest barrier to not initiating/withholding dialysis, while fellows ranked time management as the highest barrier; nephrologists identified the finality of the decision (death) as the biggest barrier to discontinuing dialysis, while fellows viewed the inertia of the clinical encounter as the highest barrier.
JOURNAL OF PALLIATIVE MEDICINE
(2021)
Review
Medicine, General & Internal
Catalina Poiana, Roxana Dusceac, Dan Alexandru Niculescu
Summary: Maintenance dialysis is associated with changes in bone metabolism and an increased risk of fracture. Dual-energy X-ray densitometry is used for assessing bone quantity and bone loss, while trabecular bone score evaluates bone microarchitecture. However, the utility of trabecular bone score in dialysis patients has not been conclusively shown.
FRONTIERS IN MEDICINE
(2022)
Article
Medicine, General & Internal
David Tipene-Leach, Anna Adcock, Sally Abel, Derek Sherwood
Summary: This study examines the perspectives of Maori patients and healthcare practitioners on the Choosing Wisely program and the shared decision-making between Maori and medical practitioners. The results highlight issues in health messaging, trust between patients and practitioners, and the need for early consultation with Maori and integration of their cultural knowledge in the program.
NEW ZEALAND MEDICAL JOURNAL
(2021)
Article
Environmental Sciences
Maria Carmen Lea-Pereira, Laura Amaya-Pascasio, Patricia Martinez-Sanchez, Maria del Mar Rodriguez Salvador, Jose Galvan-Espinosa, Luis Tellez-Ramirez, Fernando Reche-Lorite, Maria-Jose Sanchez, Juan Manuel Garcia-Torrecillas
Summary: This study aims to develop a predictive model to estimate the risk of mortality in stroke patients who have not received reperfusion treatment. The model, based on logistic regression and machine learning techniques, includes nine variables that are readily obtainable during initial care.
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
(2022)
Article
Environmental Sciences
Arim Shukri, Thomas Mettang, Benjamin Scheckel, Isabell Schellartz, Dusan Simic, Nadine Scholten, Martin Mueller, Stephanie Stock
Summary: The study compared the health economic outcomes of hemodialysis (HD) and peritoneal dialysis (PD) and found that PD had a slight cost advantage over HD. Despite the higher patient autonomy associated with PD, its uptake rate in Germany is low for unknown reasons.
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
(2022)
Article
Health Care Sciences & Services
Yi-Ting Kuo, Chang-Chyi Jenq, Uen Shuen Li, Ya-Ping Lin
Summary: This study aimed to explore physicians' responses towards patients' refusal of long-term dialysis during the SDM process and the thinking processes of both physicians and patients regarding dialysis refusal.
JOURNAL OF EVALUATION IN CLINICAL PRACTICE
(2023)
Review
Urology & Nephrology
Fahad Saeed, Amna Yousaf Shah, Rebecca Jane Allen, Ronald M. Epstein, Kevin A. Fiscella
Summary: The purpose of this review is to provide an overview of the necessary skills for communication and person-centered decision making for renal replacement therapy (RRT) choices, particularly conservative kidney management (CKM). Recent research in this area is still in its early stages, and the authors have adapted literature from primary care and oncology to help with effective RRT decision making. Seven key skills are identified, including announcing the need for decision making, educating patients about RRT options, and responding to emotions with empathy. Example sentences are also provided to guide conversations around RRT choices, including CKM.
CURRENT OPINION IN NEPHROLOGY AND HYPERTENSION
(2021)
Article
Urology & Nephrology
Shahab Bozorgmehri, Hussain Aboud, Gajapathiraju Chamarthi, I-Chia Liu, Ozrazgat-Baslanti Tezcan, Ashutosh M. Shukla, Amir Kazory, Ruchi Rupam, Mark S. Segal, Azra Bihorac, Rajesh Mohandas
Summary: The study found that early initiation of maintenance hemodialysis is associated with increased all-cause and cardiovascular mortality. Delaying hemodialysis initiation based on estimated glomerular filtration rate values may be beneficial.
HEMODIALYSIS INTERNATIONAL
(2021)
Article
Medicine, General & Internal
Habibah Sardidi, Dalal Bawazeer, Mohammed Alhafi, Shadan Alomran, Ghali Sayed
Summary: This study evaluated the feasibility of using the initial National Early Warning Score 2 (NEWS-2) as a predictive tool for in-hospital mortality in hemodialysis patients in the emergency department (ED). The results showed that NEWS-2 had higher sensitivity in predicting sepsis compared to qSOFA, while qSOFA had higher specificity in predicting mortality compared to NEWS-2.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2023)