The growing prevalence of chronic kidney disease has led to an increase in the need for renal replacement therapies. Although renal transplant is the desired choice of patient with end-stage renal disease, many patients require dialysis as a bridge to transplantation, and others may not be suitable for transplant and so require long-term dialysis. Home haemodialysis (HHD) is the most cost-effective form of dialysis and is associated with better outcomes for patients. However, similar to the case internationally, only about 2.5% of dialysis patients receive HHD in Ireland, with the vast majority of patients receiving hospital-based haemodialysis. HHD is also under-utilised internationally.
The aim of the proposed research project is to use theories of behaviour change and implementation science to provide a unified approach to identifying how to increase the uptake of HHD in Ireland. The project proposes a multi-method approach involving a range of stakeholders (patients and their carers/families, clinical staff, healthcare managers/policy makers) in order to: (1) establish the barriers to HHD for patient and their carers/families and in the healthcare system; and (2) identify appropriate intervention options necessary to increase the prevalence of HHD in Ireland.
Proposed Irish healthcare reforms aim to shift care from a hospital-centric model in order to: improve patient and service user experience; improve clinician experience; lower costs; and achieve better outcomes. Although the proposed research project will focus on HHD, its findings will also have implications for the delivery of HHD in other countries, as well as the delivery of home care more broadly. The findings from the proposed research project provide an approach for how to encourage, support, and safely deliver new types of home care both in Ireland and internationally.
