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Programmatic variation in home hemodialysis in Canada: results from a nationwide survey of practice patterns

Overview of attention for article published in Canadian Journal of Kidney Health and Disease, June 2014
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Title
Programmatic variation in home hemodialysis in Canada: results from a nationwide survey of practice patterns
Published in
Canadian Journal of Kidney Health and Disease, June 2014
DOI 10.1186/2054-3581-1-11
Pubmed ID
Authors

Robert P Pauly, Paul Komenda, Christopher T Chan, Michael Copland, Azim Gangji, David Hirsch, Robert Lindsay, Martin MacKinnon, Jennifer M MacRae, Philip McFarlane, Gihad Nesrallah, Andreas Pierratos, Martin Plaisance, Frances Reintjes, Jean-Philippe Rioux, John Shik, Andrew Steele, Rod Stryker, George Wu, Deborah L Zimmerman

Abstract

Over 40% of patients with end stage renal disease in the United States were treated with home hemodialysis (HHD) in the early 1970's. However, this number declined rapidly over the ensuing decades so that the overwhelming majority of patients were treated in-centre 3 times per week on a 3-4 hour schedule. Poor outcomes for patients treated in this fashion led to a renewed interest in home hemodialysis, with more intensive dialysis schedules including short daily (SDHD) and nocturnal (NHD). The relative infancy of these treatment schedules means that there is a paucity of data on 'how to do it'. We undertook a systematic survey of home hemodialysis programs in Canada to describe current practice patterns. Development and deployment of a qualitative survey instrument. Community and academic HHD programs in Canada. Physicians, nurses and technologists. Programmatic approaches to patient selection, delivery of dialysis, human resources available, and follow up. We developed the survey instrument in three phases. A focus group of Canadian nephrologists with expertise in NHD or SDHD discussed the scope the study and wrote questions on 11 domains. Three nephrologists familiar with all aspects of HHD delivery reviewed this for content validity, followed by further feedback from the whole group. Multidisciplinary teams at three sites pretested the survey and further suggestions were incorporated. In July 2010 we distributed the survey electronically to all renal programs known to offer HHD according to the Canadian Organ Replacement Registry. We compiled the survey results using qualitative and quantitative methods, as appropriate. Of the academic and community programs that were invited to participate, 80% and 63%, respectively, completed the survey. We observed wide variation in programmatic approaches to patient recruitment, human resources, equipment, water, vascular access, patient training, dialysis prescription, home requirements, patient follow up, medications, and the approach to non-adherent patients. Cross-sectional survey, unable to link variation to outcomes. Competition for patients between HHD and home peritoneal dialysis means that case mix for HHD may also vary between centres. There is wide variation between programs in all domains of HHD delivery in Canada. We plan further study of the extent to which differences in approach are related to outcomes.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 45 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 45 100%

Demographic breakdown

Readers by professional status Count As %
Other 7 16%
Student > Master 6 13%
Researcher 5 11%
Student > Bachelor 4 9%
Unspecified 4 9%
Other 8 18%
Unknown 11 24%
Readers by discipline Count As %
Medicine and Dentistry 18 40%
Unspecified 4 9%
Nursing and Health Professions 4 9%
Pharmacology, Toxicology and Pharmaceutical Science 2 4%
Psychology 2 4%
Other 4 9%
Unknown 11 24%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 March 2018.
All research outputs
#7,960,512
of 25,374,647 outputs
Outputs from Canadian Journal of Kidney Health and Disease
#283
of 620 outputs
Outputs of similar age
#72,499
of 244,221 outputs
Outputs of similar age from Canadian Journal of Kidney Health and Disease
#3
of 5 outputs
Altmetric has tracked 25,374,647 research outputs across all sources so far. This one has received more attention than most of these and is in the 67th percentile.
So far Altmetric has tracked 620 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.6. This one has gotten more attention than average, scoring higher than 52% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 244,221 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.
We're also able to compare this research output to 5 others from the same source and published within six weeks on either side of this one. This one has scored higher than 2 of them.