- New project could save NHS £45m over three years through allowing more dialysis patients to be treated at home
- Study will investigate why uptake of home treatment is limited and design possible solutions to improve the uptake of home therapies
- Around 30,000 kidney failure patients in the UK currently manage their condition with dialysis
- Having dialysis at home has been safer for patients during the Covid-19 pandemic
New research could save the NHS up to £45m over three years by increasing the number of dialysis patients whose treatment takes place at home.
The University of Sheffield will work with colleagues from Keele University and the University of Birmingham on the new NIHR-funded study called Inter-CEPt (Intervening to eliminate the centre-effect variation in home dialysis use), which will focus on the reasons why home therapies are not used more equally and fairly by kidney centres across the country, as well as designing and testing possible solutions to improve the uptake of home therapies.
Building on previous collaborations, this multidisciplinary project brings together health economists from the University of Sheffield with ethnographic and statistical expertise from Keele and health policy researchers from the University of Birmingham.
Around 30,000 kidney failure patients in the UK currently manage their condition with dialysis, either at home or by travelling to their local dialysis unit as an out-patient, where it is provided by healthcare staff.
Although national guidelines encourage the use of home dialysis, the uptake is limited and varies greatly by treatment centre. Some centres offer home treatments more than others, with provision varying between two and 28 per cent of patients requiring kidney replacement therapy.
Having dialysis at home is associated with improved clinical outcomes, treatment satisfaction and patient autonomy. It has also been safer for patients during the Covid-19 pandemic.
Dr James Fotheringham, from the University of Sheffield's School of Health and Related Research, is leading the health economics research for the study. He said: "The internationally renowned expertise in health economics which the School of Health and Related Research brings to this project, ensures that the costs and benefits of these important treatments are fully understood so they can inform policy and clinical practice."
Recent research by the Renal Registry has also found that certain groups in society were less likely to have home therapy, with patients from Black, Asian and Minority Ethnic (BAME) groups and those from poorer or more disadvantaged backgrounds being particularly affected.
This research aims to change the uptake and availability of home dialysis treatments, by using a five-stage approach to assess the main factors affecting home dialysis availability, which will allow the researchers to develop a practical and feasible approach for dialysis centres to make these treatments more accessible.
Professor Simon Davies from Keele's School of Medicine, is one of the project leads. He said: "We will use in depth knowledge of what constitutes a strong and equitable home therapies programme to inform a wider survey of dialysis unit practices linked to patient outcomes; this will allow us to develop a bundle of interventions designed to support inclusion of those patients into home therapies who may not currently benefit from this treatment option."
Professor Lisa Dikomitis from Keele University added: "I am delighted to be part of this timely and important study, which is underpinned by a robust patient and public involvement and engagement strategy. Ethnographic and qualitative data will provide us with a better understanding of why certain groups in our society are less likely to have home therapy and how we can improve the uptake of such therapies."
