Your voice.
Their choice.
Modern PD.*

*Modern PD is the culmination of multiple recent advancements in clinical practice and innovations in technology that, in combination, are yielding improved survival, increasing patient satisfaction and clinical outcomes that in some cases are outpacing those of HD.

Pre-dialysis patients still rely on their HCP's modality recommendation ¹

The chart to the left shows the majority of patients, 52.6%, are avid information seekers and rely on help from their HCP to choose the optimal dialysis modality. Only 22.7% prefer deciding themselves.

Pre-dialysis patients want education

Shared decision-making supports patient satisfaction and leads to an increase in patients choosing Modern PD.²

Shared decision-making is an emerging standard health practice

Shared decision-making (SDM) is a collaborative and iterative process where the clinician supports the patient to reach a treatment decision that is right for their clinical condition, lifestyle and social circumstances.⁵

The ISPD International Society for Peritoneal Dialysis (ISPD) guidelines released in 2020 reflect the beneficial effects of shared decision-making on patient dialysis treatment satisfaction.^3,4

ISPD recognises that PD can be prescribed in a variety of ways and there is a need to consider local resources, the person’s wishes regarding lifestyle, and the wishes of family members/caregivers involved in the provision of care.⁴

Most patients seek information while also wanting their HCP to help choose the dialysis modality that's best for them.¹

Pre-dialysis patients want education ¹

Patient education and effective shared decision-making can help start more patients on PD.

The chart to the left shows pre-dialysis patients are willing to be educated as they are in the high end of the information seeking percentage.

A formal pre-dialysis program where patients and HCPs share in the decision of which dialysis modality best fits the patients' goals increases the uptake of PD (or home HD).^6-18

Up to 50% of eligible patients choosing PD¹⁹
Up to 4-fold increase PD in Take-on-Rate¹⁹

Among 177 unplanned start dialysis patients who completed an education program aimed at enabling informed choice and who then chose a preferred dialysis modality, 103 (58%) chose PD and 74 (42%) chose HD.²⁰

SDM improves alignment between clinician and patient goals

Among patients on PD, there is a close alignment between the outcomes that matter to patients and those that matter to HCPs, suggesting that there is a greater satisfaction with care on PD.²¹

SDM supports patient satisfaction

Patients are most satisfied when the dialysis modality meets their requirements.² Patient education and effective shared decision-making can help place more patients on Modern PD. Patients who are engaged in shared decision-making perceived dialysis more positively.²²

The shared decision-making process

HCPs present evidence-based therapy options along with the unbiased pros and cons of each.

Patients engage in the process to the extent they desire, making their values and preferences explicit.

A mutual, informed-decision is made based on the options presented by the HCP and the preferences of the patient.

'Your voice. Their choice. Modern PD' graphic — Your voice. Their choice. Modern PD.

See References

Jayanti A, Neuvonen M, Wearden A, Morris J, Foden P, Brenchley P, et al. Healthcare decision-making in end stage renal disease-patient preferences and clinical correlates. BMC Nephrol. 2015;16: 189.
Devoe DJ, Wong B, James MT, Ravani P, Oliver MJ, Barnieh L, et al. Patient Education and Peritoneal Dialysis Modality Selection: A Systematic Review and Meta-analysis. Am J Kidney Dis. 2016;68(3): 422-433.
Blake PG, Brown EA. Person-centered peritoneal dialysis prescription and the role of shared decision-making. Peritoneal Dialysis Int. 2020;40(3) 302-309.
Brown EA, Blake PG, Boudville N, Davies S, Arteaga J, Dong J, et al. International Society for Peritoneal Dialysis practice recommendations: Prescribing high-quality good-directed peritoneal dialysis. Peritoneal Dialysis International. 2020;40(3): 244-253.
Goovaerts T, Jadoul M, Goffin E. Influence of a predialysis education program (PDEP)on the mode of renal replacement therapy. Nephrol Dial Transplant. 2005;20: 1842-1847.
Goovaerts T, Jadoul M, Goffin E. Influence of a predialysis education program on the choice of renal replacement therapy. Am J Kidney Dis. 2012;60(3):499–500.
Key SM. Optimizing dialysis modality choices around the world: a review of literature concerning the role of enhanced early pre-ESRD education in choice of renal replacement therapy modality. Nephrol Nurs J. 2008; 35(4):387–395.
Adeera L, Paul ES, Rudy WB, Josef C, Angel LM, Francisco PE, et al. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. Kidney Int Suppl. 2013;3(1):1 –150.
Mendelssohn DC, Mujais SK, Soroka SD, Brouillette J, Takano T, Barre PE, rt al. A prospective evaluation of renal replacement therapy modality eligibility. Nephrol Dial Transplant. 2009; 24(2): 555-561.
Mendelssohn DC, Curtis B. Yeates K, Langlois S, MacRae JM, Semeniuk LM, et al. Suboptimal initiation of dialysis with and without early referral to a nephrologist. Nephrol Dial Transplant. 2011; 26:2959–2965.
Levin A, Lewis M, Mortiboy P, Faber S, Hare I, Porter EC, et al. Multidisciplinary predialysis programs: quantification and limitations of their impact on patient outcomes in two Canadian settings. Am J Kidney Dis. 1997; 29(4):533–540.
Wilson SM, Robertson JA, Chen G, Krishnan M, MayneTJ, Nissenson AR, et al. The IMPACT (Incident Management of Patients, Actions Centered on Treatment) program: a quality improvement approach for caring for patients initiating long-term hemodialysis. Am J Kidney Dis. 2012;60(3): 435–443.
Manns BJ, Taub K, Vanderstraeten C, Jones H, Mills C, Visser M, et al. The impact of education on chronic kidney disease patients’ plans to initiate dialysis with self-care dialysis: a randomized trial. Kidney Int. 2005; 68(4):1777–1783.
Little J, Irwin A, Marshall T, Rayner H, Smith S. Predicting a patient’s choice of dialysis modality: Experience in a United Kingdom renal department. American Journal of Kidney Diseases. 2001;37(5): 981–986.
Ahlmen J, Carlsson L, Schonborg C. Well-informed patients with end-stage renal disease prefer peritoneal dialysis to hemodialysis. Perit Dial Int. 1993;13(2): S196–S198.
Prichard S. Treatment modality selection in 150 consecutive patients starting ESRD therapy. Perit Dial Int. 1996;16(1):69–72.
Marron B, Martinez OJC, Salgueira M, Barril G, Lamas JM, Martin M, et al. Analysis of patient flow into dialysis: role of education in choice of dialysis modality. Perit Dial Int. 2005;25(3): S56–S59.
Ribitsch W, Haditsch B, Otto R, Schilcher G, Quehenberger F, Roob JM, et al. Effects of a pre-dialysis patient education program on the relative frequencies of dialysis modalities. Perit Dial Int. 2013;33(4):367–371.
Francois K, Bergman JM. Evaluating the benefits of home-based peritoneal dialysis. Int. J. Nephrol Renovasc Dis. 2014;7:447-455.
Machowska A, Alscher MD, Vanga SR, Koch M, Aarup M, Rutherford P. Offering Patients Therapy Options in Unplanned Start (OPTiONS): Implementation of an educational program is feasible and effective. BMC Nephrology. 2017;18:18.
Manera KE, Tong A, Craig JC, Shen J, Jesudason S, Cho Y, et al. An International Delphi surrvey helped develop consensus-based core outcome domains for trials in peritoneal dialysis. Kindney Int. 2019;96(3): 699-710.
Ladin K, Lin N, Hahn E, Zhang G. Koch-Weser S, Weiner DE. Engagement in decision-making and patient satisfaction: a qualitative study of older patients’ perceptions of dialysis initiation and modality decisions. Nephrol Dial Transplant. 2017;32(8): 1394-14012.

Therapies

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Data & Insights

Your voice.
Their choice.
Modern PD.*

Pre-dialysis patients still rely on their HCP's modality recommendation ¹

The chart to the left shows the majority of patients, 52.6%, are avid information seekers and rely on help from their HCP to choose the optimal dialysis modality. Only 22.7% prefer deciding themselves.

Pre-dialysis patients want education

Shared decision-making supports patient satisfaction and leads to an increase in patients choosing Modern PD.²

Pre-dialysis patients want education ¹

Patient education and effective shared decision-making can help start more patients on PD.

The chart to the left shows pre-dialysis patients are willing to be educated as they are in the high end of the information seeking percentage.

A formal pre-dialysis program where patients and HCPs share in the decision of which dialysis modality best fits the patients' goals increases the uptake of PD (or home HD).^6-18

SDM improves alignment between clinician and patient goals

SDM supports patient satisfaction

The shared decision-making process

Want to know more? Click here to see more clinical data on Modern PD

Pre-dialysis patients still rely on their HCP's modality recommendation 1

The chart to the left shows the majority of patients, 52.6%, are avid information seekers and rely on help from their HCP to choose the optimal dialysis modality. Only 22.7% prefer deciding themselves.

Pre-dialysis patients want education

Shared decision-making supports patient satisfaction and leads to an increase in patients choosing Modern PD.2

Pre-dialysis patients want education 1

Patient education and effective shared decision-making can help start more patients on PD.

The chart to the left shows pre-dialysis patients are willing to be educated as they are in the high end of the information seeking percentage.

A formal pre-dialysis program where patients and HCPs share in the decision of which dialysis modality best fits the patients' goals increases the uptake of PD (or home HD).6-18

SDM improves alignment between clinician and patient goals

SDM supports patient satisfaction

The shared decision-making process

Want to know more? Click here to see more clinical data on Modern PD

Pre-dialysis patients still rely on their HCP's modality recommendation ¹

Shared decision-making supports patient satisfaction and leads to an increase in patients choosing Modern PD.²

Pre-dialysis patients want education ¹

A formal pre-dialysis program where patients and HCPs share in the decision of which dialysis modality best fits the patients' goals increases the uptake of PD (or home HD).^6-18