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Review of predialysis education programs: a need for standardization

Authors Van den Bosch J, Warren DS, Rutherford PA

Received 22 January 2015

Accepted for publication 10 April 2015

Published 9 September 2015 Volume 2015:9 Pages 1279—1291

DOI https://doi.org/10.2147/PPA.S81284

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Johnny Chen


Judith Van den Bosch,1 D Simone Warren,1 Peter A Rutherford2

1Pallas Health Research and Consultancy BV, Rotterdam, the Netherlands; 2Baxter Healthcare SA, Zürich, Switzerland

Abstract: To make an informed decision on renal replacement therapy, patients should receive education about dialysis options in a structured program covering all modalities. Many patients do not receive such education, and there is disparity in the information they receive. This review aims to compile evidence on effective components of predialysis education programs as related to modality choice and outcomes. PubMed MEDLINE, Cochrane Library, and Ovid searches (from January 1, 1995 to December 31, 2013) with the main search terms of “predialysis”, “peritoneal dialysis”, “home dialysis”, “education”, “information”, and “decision” were performed. Of the 1,005 articles returned from the initial search, 110 were given full text reviews as they potentially met inclusion criteria (for example, they included adults or predialysis patients, or the details of an education program were reported). Only 29 out of the 110 studies met inclusion criteria. Ten out of 13 studies using a comparative design, showed an increase in home dialysis choice after predialysis education. Descriptions of the educational process varied and included individual and group education, multidisciplinary intervention, and varying duration and frequency of sessions. Problem-solving group sessions seem to be an effective component for enhancing the proportion of home dialysis choice. Evidence is lacking for many components, such as timing and staff competencies. There is a need for a standardized approach to evaluate the effect of predialysis educational interventions.

Keywords: dialysis, end-stage renal disease, informed decision, modality choice

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