Keele University

ILD63

Home dialysis usage varies widely by centre, despite clear economic and likely patient benefits. This includes poorer access to home dialysis for deprived/BAME populations. The reasons for these differences are unclear. WP1 – We will study 4 centres, selected to represent good and average practice, including areas with significant BAME and deprived populations. Non-participant observation, plus think-aloud interviews and semi-structured interviews of staff and patients will be used. WP2 – Detailed survey of all English renal units describing characteristics at each centre that are relevant to home dialysis usage. These results will be combined with patient-level Registry data and analysed using statistical models to identify potentially important drivers of home dialysis and to estimate of the effects of changing practices. WP3 – A health economic model will be developed to identify the potential costs or savings of changing practices. WP4 - We will synthesise and interpret all of the data in order to develop a number of potential intervention bundles that could reduce/eliminate differences between renal centres in home therapy uptake. The impact of these bundles will then be assessed for the trade-off between benefits and costs. WP5 - We will develop an intervention by co-design in two workshops, with representation from doctors, nurses, allied health professionals, patients and policy leads. This study will produce the most detailed understanding of drivers of home dialysis usage and the patient and health economic benefits associated with effective interventions. Patients will benefit through introduction of an intervention that will address between-centre variation, as well as improved access to home dialysis for deprived and BAME groups where there is currently variability in practice and outcome.

04/06/2020